Pretreatment with intravitreal bevacizumab (Avastin, Genentech) in vitrectomy may help improve outcomes for severe diabetic retinopathy (DR), according to a study in the British Journal of Ophthalmology.1
Li-Quan Zhao, MD, of Xinhua Hospital in Shanghai, and colleagues conducted a comprehensive literature search to identify randomized, controlled trials and comparative studies of vitrectomy with or without bevacizumab pretreatment for severe or complicated DR. The investigators performed meta-analyses for intraoperative outcome parameters (intraoperative bleeding, endodiathermy, iatrogenic retinal tears, and mean surgical time) and postoperative outcome parameters (best corrected visual acuity [BCVA], recurrent vitreous hemorrhage, reabsorption time of blood, and other complications).
Overall, 6 trials and 1 study were used for comparing vitrectomy alone (142 eyes, control group) with vitrectomy with intravitreal bevacizumab pretreatment (139 eyes). Incidence of intraoperative bleeding and frequency of endodiathermy were statistically significantly less in patients who were pretreated with bevacizumab compared with those who were not (P < .01). The bevacizumab-pretreatment group also required significantly less surgical time than the control group (P = .003). Postoperative outcomes showed that blood reabsorption time was significantly shorter (P = .04), incidence of recurrent vitreous hemorrhage was insignificantly less (P = .05), and final BCVA was significantly better (P = .003) in the bevacizumab-pretreatment group. Other complications were not statistically significant. “[Intravitreal bevacizumab pretreatment] in vitrectomy can achieve excellent clinical outcomes for severe [DR],” the study authors wrote. “It potentially facilitates surgeons’ [maneuvers] and reduces intra- and postoperative complications.”
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