Intravitreal injection of angiogenesis inhibitors as a stage of sparing vitreoretinal surgery of proliferative diabetic retinopathy

Purpose: To evaluate the effect of intravitreal injection of Lucentis (IVL) on diabetic vitrectomy and on the postoperative course. Methods: 41 patients (63 eyes) undergoing diabetic vitrectomy were distributed to sparing vitrectomy (group I) or vitrectomy with preoperative IVL (group II). Lucentis was injected 2 to 4 days before surgery. Patients of both groups were matched as much as possible according to surgical indication and preoperative visual acuity. Main outcome measures were the feasibility of surgery and the postoperative complications. Feasibility of surgery was evaluated through recording surgical time, intraoperative bleeding, use of endodiathermy, use of silicone oil tamponade. Results: Follow up ranged between 5 and 6 months. There was significant reduction of mean surgical time, bleeding frequency, and diathermy use in group II compared to group I. Gas or air was used in 83,3% of patients in group II while silicone oil represented 66,7% of group I. Postoperative visual acuity improvement was highly significant in both groups. Postoperative bleeding was reported in 22,2% of cases in group I and in 5,6% in group II. In group II, no complications related to Lucentis injection or progression of traction were reported during the preoperative period. Conclusion: Preoperative IVL was helpful in achieving the surgical and anatomical goals by reducing the time of surgery, the intraoperative and postoperative bleeding, and the use of silicone oil with subsequent reduction of second surgery.