The Observation Of Intravitral Lucentis In Before Vitrectomy For PDR

Objective: To investigate the impact of intravitreal injection ofLucentis before vitrectomy of proliferative diabetic retinopathy(PDR).Methods：Collected the clinical data of54cases（72eyes）ofproliferative diabetic retinopathy treated with vitrectomy,Department ofOphthalmology,the First Affiliated Hospital of Chongqing medicaluniversity during September,2012to September,2013.Cases have beendivided into three groups including Lucentis group,TA group,controlgroup,according to whether taking intravitreal injection and the differentdrugs.Lucentis group(21cases,27eyes) treated with vitrectomy afterinjection of intravitreal Lucentis.TA group(14cases,17eyes) tookvitrectomy after intravitrea TA injection.The remaining patients(19cases,28eyes) accepted vitrectomy directly as the control group.For allpatients, we observed and recorded the data of treatment process andfollow-up within3-6months,and statistical analyze the clinical efficacy ofthree groups.Results：1.3to5days after accepted Lucentis,vitreous hemorrhageabsorbed partially, retinal neocacular membrane fibrosis changed and atrophied. There’s no significant adverse reactions or systemiccomplications.2. Compare with control group, Lucentis group excessiebleeding rate is less than the control group, P=0.02;In the comparison of Agroup and the control group, P=0.70, prompting no statisticallydifference; Also, there is no statistical significance between Lucentis andTA group, P＞0.05.3. The incidence of iatrogenic retinal Lucentis groupin less than the control group (P=0.04<0.05), but no statisticallysignificance between Lucentis and TA group (P＞0.05).4. Lucentis groupcan significantly shorten the operation time compared with control group(P <0.01). Lucentis group compared with TA group, P=0.10>0.05,difference is not statistically.5. Compared with the control group: Lucentisgroup can significantly reduce the rate of postoperative vitreoushemorrhage, p=0.01; Lucentis and TA group in the control ofpostoperative of vitreous hemorrhage has no statistical significance (P＞0.05).6. Compare the poor eyesight value comparison before and afteroperation between Lucentis group and the control group, p <0.01, saidLucentis group visual improved more than the control group，and issuperior to the TA group with p value0.01.7. FFA and OCT examinationresults suggest Lucentis group appear vascular leakage, cases of macularedema and large infusion area ratio is less than the TA group and thecontrol group obviously, but no obvious difference between TA group andthe control group. Conclusions:1.PDR patients show significant changes inneovascularization fibrosis and atrophy in3-5days after Lucentisinjections.2.PDR patients suffered Lucentis injection treated withvitrectomy can prominently raise efficiency, reduce iatrogenic retinalbreaks, hemorrhage in-after operation.3.PDR patients treated withLucentis injection exerted positive visual acuity after surgery, alsoinhibited the progress of disease postoperatively.4.Lucentis intravitrealinjection has higher security.5.The best time of vitrectomy still needsfurther discussion.6.The patients of PDR suffered TA injection can reduceoperation time, was beneficial to decrease the rate of postoperativehemorrhage.6.PDR patients treated with vitrectomy within7days after TAinjection has a relatively high level of security, but the surgery time andlong-term security need to be studied further.