http://www.dailymotion.com/video/xn6rkh

Satyen Deka, H Bhattacharjee, H Deka, M J Barman, R Saibum, S M Das (Guwahati, India)

Advantages:

Preoperative intravitreal bevacizumab in diabetic tractional retinal detachment (TRD) facilitates surgery, decreases the intraoperative bleeding and improves the visual acuity.

Methods:

In this non comparative interventional case series 10 eyes of 8 candidate diabetic TRD patients received 1.25 mg intravitreal off level bevacizumab 2-7 days prior to operation. Surgical steps included vitrectomy with removal of the posterior hyaloid & epiretinal membrane, endolaser, and fluid-gas exchange. Long-acting gas tamponade used if necessary. Amount of intraoperative bleeding, retinal break, number of endodiathermy application, time of raised intraocular pressure, postoperative visual acuity and recurrent vitreous hemorrhage were recorded. Minimum follow up was 3 months.

Effectiveness / Safety:

Intravitreal bevacizumab prior to vitreous surgery resulted in easy removal of epiretinal membrane (90%) cases with significantly less intraoperative bleeding. Visual acuity improvement in 8/10 eyes (80%). Recurrent hemorrhage occurred in 1/10 eyes (10%) and in 1/10 eye (10%) intraoperative retinal break encountered.

Take home message:

Intravitreal bevacizumab prior to vitrectomy for diabetic TRD facilitates surgery, decreases the amount of intraoperative bleeding, retinal complications and improves the visual acuity.