Bevacizumab prior to vitrectomy for diabetic traction retinal detachment

To assess the efficacy and safety of preoperative intravitreal bevacizumab (IVB) before vitrectomy for diabetic tractional retinal detachment (TRD).

Using ICD-9 codes, we located all patients with diabetic TRD who underwent 3-port 20-gauge vitrectomy primarily performed by one surgeon between January 2004 and January 2009. Eyes receiving IVB were compared with those not. The following outcomes were compared: visual acuity (VA), duration of surgery, and complication rates.

A total of 99 eyes of 90 patients were included in the analysis. In all, 34 patients received IVB on an average of 11.5 (range, 3-30) days previtrectomy. Age was 46.5 and 51.6 in the IVB and non-IVB groups, respectively. VA was improved significantly in both groups: from 20/617 to 20/62 in the IVB group, and from 20/443 to 20/86 in the non-IVB group (P=0.11 between groups). Operating time and postoperative complications (glaucoma, RD, and revitrectomy rate) were similar in both groups. On comparing IVB and non-IVB eyes in younger patients (≤ 40), operating time was shorter (P=0.02) and a trend to better VA in the IVB group was seen.

Preoperative IVB may be a useful adjunct to vitrectomy for severe PDR complicated by TRD, particularly in younger diabetics.