Role of bevacizumab in the prevention of early postoperative haemorrhage after 25-gauge microincision vitrectomy surgery

Abstract

Objective:To evaluate the effect of preoperative intravitreal bevacizumab injection on the incidence of postoperative haemorrhage and visual prognosis, in patients undergoing 25-gauge micro incision vitrectomy surgery (MIVS) for diabetic vitreous haemorrhage.Methods:One hundred and twenty two eyes of 122 patients of diabetic retinopathy of both genders and aged over 18 years, who presented with non-resolving vitreous haemorrhage were enrolled for this study. All patients received an intravitreal injection of 1.25 mg/0.05 mL bevacizumab (Avastin) which was followed one week later by 25-gauge sutureless micro incision vitrectomy surgery. Main outcomes measured were best corrected visual acuity (BCVA) assessed with logMAR and post-operative vitreous haemorrhage. Follow ups were up to six months post-operatively. IBM SPSS 21 was used for data analysis.Result:A total of 122 patients were included; 78 (63.9%) males and 44 (36.1%) females. Mean age at the time of surgery was 51.4 ± 13.66 years. The mean preoperative BCVA was 1.64 ± 0.427 logMAR which improved to 0.57 ± 0.253 logMAR at 12 months post-operatively (p-value < 0.001). Recurrent vitreous haemorrhage was seen in four patients (3.28%).one1 week before 25-gauge vitrectomy helps to reduce the incidence of early post-vitrectomy haemorrhage in diabetic patients.

Endophthalmitis Postintravitreal Bevacizumab Injections

“…Intravitreal injections (IVIs) have become part of the standard regimen for inhibiting vascular endothelial growth factor (VEGF) and thereby, managing and improving the visual prognosis in cases of diabetic macular edema, retinal vein occlusion, age-related macular degeneration, etc. [ 1 2 ] Whereas IVIs are largely safe to use, they do run a slight risk of unwanted side effects including sterile inflammation, intraocular pressure elevation, endophthalmitis, retinal detachment, and vitreous hemorrhage. [ 3 ]…”

Outcomes of preoperative bevacizumab in diabetics with nonclearing vitreous hemorrhage without tractional detachment – A quasi-randomized retrospective study

“…Though previous studies looked at best-corrected vision (BCVA) as a major outcome measure, they evaluated this in terms of residual VH and not central macular thickness (CMT) in this subgroup of treatment-naïve eyes. [ 9 17 18 19 ] Even though the outcomes in these eyes are expected to be excellent with timely pars plana vitrectomy and endolaser, the CMT, incidence of center-involving diabetic macular edema (ciDME), and BCVA at the 1-month postoperative time point in relation to the anatomic macular features have not been elucidated well. Additionally, the need for adjuvant intravitreal pharmacotherapy up to 6 months follow-up after vitrectomy and influence of preoperative anti-VEGF on this has also not been studied well in this subgroup.…”