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Lookup NU author(s): Professor David SteelORCiD
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Purpose The purpose of this study is to evaluate the efficacy of preoperative intravitreal bevacizumab (IVB) for improving outcomes in vitrectomy for diabetic retinopathy-related non-clearing vitreous haemorrhage and/or tractional retinal detachment.Methods Medical record from patients undergoing vitrectomy for proliferative diabetic retinopathy (PDR) were retrospectively analysed (2003-2011). From 2007, IVB (1.25 mg 2-4 days before operating) was used on all eyes. Eyes receiving IVB were compared with those that did not receive IVB. Intraoperative complications, reoperation rates, and final visual acuity were the core outcome measures.Results Data were analysed for 88 patients (101 eyes). In all, 41 (41%) patients had received IVB, whereas 60 (59%) patients had not. Significant intraoperative haemorrhage occurred in six eyes (10%) in the non-IVB group and in one (2.4%) IVB eyes (P = 0.24). Silicon oil was used in 29 (48%) non-IVB eyes and in 11 (27%) IVB eyes (P = 0.03). The non-IVB eyes underwent significantly more vitreoretinal reoperations (P = 0.01) and were significantly more likely to lose two or more lines of vision at the final follow-up (P = 0.03). The numbers needed to treat (NNT) blindness (<3/60) was four for non-IVB eyes and two for the IVB group.Conclusions IVB reduces surgical complications, the use of silicon oil, and the need for further retinal surgery. The NNT to restore useful vision (>= 3/60) to a blind eye were significantly lower in the IVB group. Vitreoretinal surgery for the complications of PDR is effective in an East African context, and IVB should be considered a valuable adjunct.
Author(s): Guthrie G, Hall AB, Dhalla K, Davis RM, Steel DH
Publication type: Article
Publication status: Published
Print publication date: 01/11/2013
Online publication date: 16/08/2013
Acceptance date: 23/07/2013
ISSN (print): 0950-222X
ISSN (electronic): 1476-5454
Publisher: Nature Publishing Group
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