scholarly journals Efficacy and Safety of Intravitreal Conbercept, Ranibizumab, and Triamcinolone on 23-Gauge Vitrectomy for Patients with Proliferative Diabetic Retinopathy

2018 ◽  
Vol 2018 ◽  
pp. 1-11 ◽  
Author(s):  
Jinglin Cui ◽  
Hong Chen ◽  
Hang Lu ◽  
Fangtian Dong ◽  
Dongmei Wei ◽  
...  
Keyword(s):  
Diabetic Retinopathy ◽  
Proliferative Diabetic Retinopathy ◽  
Silicone Oil ◽  
Operation Time ◽  
Intravitreal Ranibizumab ◽  
Intravitreal Triamcinolone ◽  
Retinal Breaks ◽  
Pars Plana ◽  
Silicone Oil Tamponade ◽  
23 Gauge

Introduction. To compare the effect and safety of intravitreal conbercept (IVC), intravitreal ranibizumab (IVR), or intravitreal triamcinolone acetonide (IVTA) injection on 23-gauge (23-G) pars plana vitrectomy (PPV) for proliferative diabetic retinopathy (PDR). Methods. Fifty patients (60 eyes) of varying degrees of PDR were randomly grouped into 3 groups (1 : 1 : 1) (n=20 in each group). The 23-G PPV was performed with intravitreal conbercept or ranibizumab injection 3–7 days before surgery or intravitreal TA injection during surgery. The experiment was randomized controlled, with a noninferiority limit of five letters. Main outcome measures included BCVA, operation time, incidence of iatrogenic retinal breaks, endodiathermy rate, and silicone oil tamponade. Results. At 6 months after surgery, there were no significant differences of BCVA improvements, operation time, incidence of iatrogenic retinal breaks, endodiathermy rate, silicone oil tamponade, vitreous clear-up time, and the incidence of intraoperative bleeding between the IVC and IVR groups (all P values ≥ 0.05), but they were significantly different from the IVTA group (all P values < 0.05). IOP increases did not show significant differences between the IVC and IVR groups, but both were significantly different with the IVTA group. More patients had higher postoperative IOP in the IVTA group. Conclusions. The intravitreal injection of conbercept, ranibizumab, or TA for PDR had a significant different effect on outcomes of 23-G PPV surgery. Conbercept and ranibizumab can reduce difficulty of the operation, improve the success rate of PPV surgery, and decrease the incidence of postoperative complications.

scholarly journals Ocular biometry and refractive changes post sutureless vitrectomy surgery

2019 ◽  
Vol 1 (2) ◽  
pp. 114-125
Author(s):  
Raja nor farahiyah Raja othman
Keyword(s):  
Silicone Oil ◽  
Anterior Chamber Depth ◽  
Ocular Biometry ◽  
Myopic Shift ◽  
Before And After ◽  
Pars Plana ◽  
Silicone Oil Tamponade ◽  
The Mean ◽  
23 Gauge ◽  
Patients Experience

Introduction: Pars plana vitrectomy (PPV) without endotamponade should not induce significant change to the refractive status of the eye. However, several studies have reported minor refractive changes after plain vitrectomy. Purpose: To compare the changes in refraction following PPV and to examine the biometry parameters that may affect the refractive change.Materials and methods: In this prospective cohort study, patients who were listed for 23-gauge 3-port PPV without buckling or silicone oil tamponade were enrolled between December 2015 and September 2017. Autorefraction, keratometry, anterior chamber depth (ACD), and axial length (AL) were measured preoperatively and three months postoperatively.Results: This study involved 41 eyes from 38 patients. The mean spherical equivalent (SE) before PPV was -1.08 dioptres (D), (standard deviation (SD) 2.18), which changed to a mean of -1.88 D (SD 2.20) postoperatively. The mean SE change was -0.80 D (SD 1.61, 95% confidence interval (CI) -1.31 to 0.30 D, P = 0.003). The median astigmatism before PPV was 0.69 D (Interquartile range (IQR) 0.69 D) reduced to 0.66 D (IQR 0.60 D) after PPV (P = 0.882). Median ACD preoperatively was 3.55 mm (IQR 0.76 mm) and reduced postoperatively to 3.44 mm (IQR 0.67 mm), (P = 0.028). The median AL was 23.36 mm (IQR 1.42 mm) and 23.48 mm (IQR 1.56 mm) before and after PPV, respectively, (P = 0.029). No significant SE change was found between phakic and pseudophakic groups (P = 0.155).Conclusion: Patients experience myopic shift post plain PPV, possibly due to the reduction of ACD. The ACD tended to be shorter in the pseudophakic group, suggesting that the myopic shift in the phakic group may be a result of the development of nuclear sclerosis cataract.

Changes of the level of pro- and anti-inflammatory cytokines in tear of patients with advanced proliferative diabetic retinopathy and complicated primary cataract depending on the volume vitreoretinal surgery

2021 ◽  
pp. 82-86
Author(s):  
K.I. Konovalova ◽  
◽  
M.M. Shishkin ◽  
Keyword(s):  
Diabetic Retinopathy ◽  
Inflammatory Cytokines ◽  
Proliferative Diabetic Retinopathy ◽  
Silicone Oil ◽  
Vitreoretinal Surgery ◽  
Second Step ◽  
Iol Implantation ◽  
Keywords Cytokines ◽  
Silicone Oil Tamponade ◽  
Anti Inflammatory

Purpose. The aim is to estimate the content of pro- and anti-inflammatory cytokines (IL-1β, IL-8, IL-10, MCP-1, ICAM-1, VEGF) in tear of patients with advanced proliferative diabetic retinopathy and complicated primary cataract after phacoemulsification surgery and IOL implantation with vitreoretinal surgery accomplished at once in comparison with vitreoretinal surgery only. Material and methods. 34 cases of surgery treatment of patients with PDR and complicated primary cataract were enrolled. This patients were divided into two groups depending on the treatment tactics. In the 1st group patients were subjected to a two–step surgical procedure: vitreoretinal surgery (VRS) with silicone oil tamponade performed as the 1st step in their treatment; followed by the 2nd step, phacoemulsification surgery and silicone oil removal, and the IOL implantation, respectively. In the 2nd group phacoemulsification performed simultaneously with vitreoretinal surgery: phacoemulsification, IOL implantation, vitreoretinal surgery with silicone oil tamponade. The second step differed in the removal of silicone oil from the vitreous cavity. On the 2nd day after the 1st step surgery and before surgical treatment the tear samples of the patients of both groups have been examined. Results. A concentration of the following cytokines: IL-8, MCP-1, ICAM-1 in the 2nd group was 2,5-5 times higher than in the 1st group. Conclusion. The research revealed that the patients with advanced PDR are accurately determined by the increased concentration of IL-8, MCP-1, ICAM-1 in tear after phacoemulsification surgery and IOL implantation with vitreoretinal surgery accomplished at once in comparison with vitreoretinal surgery only. Keywords: cytokines, diabetic retinopathy, cataract, vitreoretinal surgery.

Results of improved vitreoretinal surgery at proliferative diabetic retinopathy

2021 ◽  
pp. 47-52
Author(s):  
M.M. Bikbov ◽  
◽  
M.R. Kalanov ◽  
Keyword(s):  
Diabetic Retinopathy ◽  
Intravitreal Injection ◽  
Proliferative Diabetic Retinopathy ◽  
Silicone Oil ◽  
Angiogenesis Inhibitors ◽  
Internal Limiting Membrane ◽  
Internal Limiting Membrane Peeling ◽  
Membrane Peeling ◽  
Optimal Period ◽  
Silicone Oil Tamponade

Purpose. To improve the technology of combined vitreoretinal intervention, including preliminary intravitreal injection of angiogenesis inhibitors followed by vitrectomy and a differentiated approach to internal limiting membrane peeling in patients with proliferative diabetic retinopathy (PDR). Material and methods. The research based on analysis of morpho-functional parameters 134 patient's eyes with PDR during type II diabetes mellitus. The patients were divided into 2 groups. The first group consisted of 30 patients (30 eyes), who were determined optimal period for vitrectomy. That patients underwent fundus photography and optical coherence tomography during 1 month after intravitreal injection of ranibizumab. Vitrectomy was performed within 1-3 months (38.4 ± 5.6 days). The second group consisted of 104 patients (104 eyes) who underwent vitrectomy with a differentiated approach to internal limiting membrane peeling and tamponade of the vitreous cavity. Results. The optimal period for vitrectomy in patients with PDR is 10-14 days after preliminary ranibizumab injection, which is due to the maximal regression of neovascularization and minimal traction on the retina (the risk of developing local traction retinal detachment decreases by 36.6%). Carrying out vitrectomy in optimal period helped to reduce the risk of intraoperative hemorrhagic complications by 4.2 times, the frequency of using perfluorocarbons by 3.7 times. At postoperative period, in patients without internal limiting membrane peeling on the silicone oil tamponade, the risk of epiretinal fibrosis increased 2.7 times compared with the data before treatment, and 1.8 times on air-gas mixture tamponade. Conclusion. The optimal surgical tactic for patients with PDR is preliminary intravitreal injection of angiogenesis inhibitors before vitrectomy, internal limiting membrane peeling at silicone oil tamponade (frequency of epiretinal fibrosis 96%) and individual approach to surgical correction of macular area at gas-air mixture tamponade (frequency of epiretinal fibrosis 36%), which allows to achieve a progressive improvement in morphological and functional results. Key words: proliferative diabetic retinopathy, preliminary anti-VEGF therapy, vitrectomy, internal limiting membrane peeling.

Intravitreal Triamcinolone Acetonide as an Additional Tool in Pars Plana Vitrectomy for Proliferative Diabetic Retinopathy

2003 ◽  
Vol 13 (5) ◽  
pp. 468-473 ◽  
Author(s):  
J.B. Jonas ◽  
A. SÖfker ◽  
R. Degenring
Keyword(s):  
Visual Acuity ◽  
Diabetic Retinopathy ◽  
Triamcinolone Acetonide ◽  
Proliferative Diabetic Retinopathy ◽  
Pars Plana Vitrectomy ◽  
Control Group ◽  
Study Group ◽  
Intravitreal Triamcinolone ◽  
Intravitreal Triamcinolone Acetonide ◽  
Pars Plana

Purpose To evaluate the safety and efficacy of intravitreal injections of crystalline triamcinolone acetonide as an adjunctive procedure in pars plana vitrectomy for proliferative diabetic retinopathy. Methods This nonrandomized comparative study included 30 patients (32 eyes) who underwent standardized pars plana vitrectomy for treatment of proliferative diabetic retinopathy and who received an intravitreal injection of 25 mg triamcinolone acetonide at the end of surgery. Mean follow-up time was 5.60 ± 5.14 months. The study group was compared with a control group (32 eyes) matched with the study group for preoperative and intraoperative parameters and who underwent pars plana vitrectomy for proliferative diabetic retinopathy without intravitreal injection of triamcinolone acetonide. Results The study group and the control group did not vary significantly in frequency of postoperative retinal detachment, re-pars plana vitrectomy, or postoperative enucleation or phthisis bulbi, or in best postoperative visual acuity, visual acuity at end of the study, or gain in visual acuity. Conclusions In this pilot study, the study group with pars plana vitrectomy and intravitreal triamcinolone acetonide injection compared with the nonrandomized control group without intravitreal triamcinolone acetonide injection did not show a higher than usual rate of postoperative complications. As a corollary, however, the data do not suggest the adjunct use of 25 mg intravitreal triamcinolone acetonide combined with pars plana vitrectomy as treatment of proliferative diabetic retinopathy.

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