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Updated: Jun 4, 2026

Implantation Protocol of the Foldable Capsular Vitreous Body for Complex Vitreoretinal Surgery
Published on: April 14, 2026
Vitreous web after pars plana vitrectomy and bevacizumab with fluid-air exchange
Allen Chiang1, Shantan Reddy, Irena Tsui
1Department of Ophthalmology, Jules Stein Eye Institute, University of California, Los Angeles, CA 90095, USA.
Background:
Intravitreal bevacizumab may result in intraocular inflammation of infectious and non-infectious etiology. Appropriate recognition of a sterile process can circumvent unnecessary treatment for endophthalmitis.
Design:
Observational case report.
Methods:
A marked web-like inflammatory response within the vitreous following intraoperative intravitreal bevacizumab is described in a patient with pre-proliferative diabetic retinopathy, macular edema, and epiretinal membrane who underwent pars plana vitrectomy, membrane peel, endolaser, and fluid-air exchange. Wide-field fundus photography captured the full extent of this reaction.
Results:
On post-operative day one, the patient presented with vitreous opacities in the form of a web of multiple white strands inferior to an air bubble, with minimal anterior or vitreous cell. At one week, the inflammatory reaction had completely resolved.
Conclusion:
Existing reports of intraocular inflammation following intravitreal bevacizumab range from uveitis to infectious endophthalmitis. With wide-field fundus imaging, we report an acute, marked web-like inflammatory response following intraoperative intravitreal bevacizumab that resolved spontaneously.
Insights
Intraocular inflammation after intravitreal bevacizumab can mimic infection. A unique web-like inflammatory response was observed post-operatively, resolving spontaneously without treatment.
Area of Science:
- Ophthalmology
- Retinal Diseases
- Surgical Complications
Background:
- Intravitreal bevacizumab is used for retinal conditions but can cause intraocular inflammation.
- Inflammation can be infectious or non-infectious, requiring accurate diagnosis to avoid unnecessary treatment.
Observation:
- A case report details a patient with diabetic retinopathy, macular edema, and epiretinal membrane.
- The patient received intraoperative intravitreal bevacizumab during pars plana vitrectomy and related procedures.
- Wide-field fundus photography documented a distinct web-like inflammatory response in the vitreous.
Findings:
- Post-operative day one revealed vitreous opacities forming a web-like structure.
- Minimal anterior chamber or vitreous cell was present, suggesting a sterile inflammatory process.
- The inflammatory reaction completely resolved within one week.
Implications:
- This case highlights a specific sterile inflammatory pattern following intravitreal bevacizumab.
- Differentiating this sterile inflammation from infectious endophthalmitis is crucial for appropriate patient management.
- Wide-field imaging aids in characterizing and monitoring such post-operative inflammatory responses.
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