Abstract

SAFETY AND EFFICACY OF PREOP INTRAVITREAL TRIAMCINOLONE PLUS BEVACIZUMAB COMBINATION AND BEVACIZUMAB ALONE IN VITREOUS SURGERY FOR NON-RESOLVING VITREOUS HAEMORRHAGE IN PROLIFERATIVE DIABETIC RETINOPATHY (PDR)

Author(s): Pramod Kumar Sharma, Nisha Jha, Jagadish Prasad Rout, Ravindra Kumar Chowdhury, Sharmistha Behera, Kalyani Patra

BACKGROUND Diabetic retinopathy is much prevailing and contributing a major cause for visual morbidity, even a leading cause of total blindness among the people in their productive lifespan. Proliferative diabetic retinopathy is a major contributor to severe vision loss, very difficult to treat and requires complex surgical procedure. Here, we are suggesting our adjunctive procedure to standard diabetic vitrectomy to make the surgery little easier, shorter, safer and efficacious. The aim of the study is to know the safety and efficacy of preoperative Intravitreal (IV) triamcinolone acetonide (2 mg) plus bevacizumab (1.25 mg) and intravitreal bevacizumab (1.25 mg) 3 days prior to the scheduled day of vitreous surgery in non-resolving vitreous haemorrhage in PDR. MATERIALS AND METHODS Prospective comparative study involving 28 PDR patients with non-resolving vitreous haemorrhage planned for surgery. Group 1 (n=15), IV triamcinolone acetonide (2 mg) + bevacizumab (1.25 mg) and group 2 (n=13) IV bevacizumab (1.25 mg). Preoperative Complexity Score (CS), surgical time, intraoperative manoeuvers, visual and anatomical outcome at 6 months observation. RESULTS CS was similar in both the groups (5.5) intraoperative bleeding grade 1 vs. 2, endodiathermy 2 vs. 5 and posterior vitreous detachment induction 2 vs. 5. Postoperative best corrected visual acuity improved more in group 1 than 2. CONCLUSION Safety and efficacy of preoperative IV triamcinolone + bevacizumab is better than IV bevacizumab alone in diabetic haemorrhage related vitreous surgery.