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BIBTEX RIS

Preoperative Bevacizumab for Tractional Retinal Detachment in Proliferative Diabetic Retinopathy: A Prospective Randomized Clinical Trial

2019; Elsevier BV; Volume: 207; Linguagem: Inglês

10.1016/j.ajo.2019.05.007

1879-1891

J. Fernando Arévalo, Andrés F. Lasave, Igor Kozak, Saba Al Rashaed, Eman Al Kahtani, Maurício Maia, Michel Eid Farah, Caroline Cutolo, Miguel Brito, Claudia Osorio, Patricia Navarro, Lihteh Wu, María H. Berrocal, Virgilio Morales-Cantón, Martín Serrano, Federico Graue‐Wiechers, Nelson Alexandre Sabrosa, Arturo Alezzandrini, Roberto Gallego‐Pinazo, J. Fernando Arévalo, T.Y.A. Liu, Lihteh Wu, Andrés F. Lasave, Michel Eid Farah, Maurício Maia, Fernando M. Penha, Eduardo B. Rodrigues, Virgilio Morales-Cantón, Jans Fromow-Guerra, José Luis Guerrero-Naranjo, José Dalma-Weiszhausz, Raúl Vélez-Montoya, Hugo Quiroz–Mercado, Ferdinand Rodriguez, Flor E. Gómez, Anne Charlotte Brieke, A. Goveto, María H. Berrocal, Vanessa Cruz-Villegas, Federico Graue‐Wiechers, David Lozano-Rechy, Emiliano Fulda-Graue, José A. Roca, Ángeles Hernández, Mario Saravia, Ariel Schlaen, Jorge Rojas, Mariana Ingolotti, Marcos Pereira de Ávila, L. Carla, J.A. Cardillo, Rodrigo Jorge, Cristián Carpentier, J. Verdaguer T, J.I. Verdaguer D, G Sepúlveda, Arturo Alezzandrini, B. Garcia, Marcelo Zas, Roberto Gallego‐Pinazo, M. Díaz-Llopis, Rosa Dolz‐Marco, M. Figueroa, Inés Contreras, Diego Ruiz-Casas,

Retinal and Macular Surgery

Purpose To assess the effectiveness and safety of an intravitreal injection of 1.25 mg bevacizumab (IVB) as a preoperative adjunct to small-gauge pars plana vitrectomy (PPV) compared with PPV alone in eyes with tractional retinal detachment secondary to proliferative diabetic retinopathy. Methods This prospective, double-masked, randomized, multicenter, active-controlled clinical trial enrolled 224 eyes of 224 patients between November 2013 and July 2015. All eyes underwent a baseline examination including best-corrected visual acuity, color photos, optical coherence tomography, and fluorescein angiography. Data were collected on intraoperative bleeding, total surgical time, early (<1 month) postoperative vitreous hemorrhage, and mean change in best-corrected visual acuity at 12 months. P < .05 was considered statistically significant. Results A total of 214 patients (214 eyes) were randomized in a 1:1 ratio to PPV plus IVB ([study group] 102 eyes) or PPV plus sham ([control] 112 eyes). Iatrogenic retinal breaks were noted intraoperatively in 35 eyes (34.3%) in the study group, and 66 eyes (58.9%) in the control group ( P = .001). Grade 2 intraoperative bleeding was noted in 32 (31.3%) eyes in the study group and 58 (51.7 %) eyes in the control group ( P = .001). Endodiathermy was necessary in 28 (27.4 %) eyes in the study group, compared with 75 (66.9%) eyes in the control group ( P = .0001). Mean surgical time was 71.3 ± 32.1 minutes in the study group and 83.6 ± 38.7 minutes in the control group ( P = .061). Conclusion Preoperative IVB seems to reduce intraoperative bleeding, improving surgical field visualization, and reducing intraoperative and postoperative complications. NOTE: Publication of this article is sponsored by the American Ophthalmological Society.