Study On The Effect Of Conbercept Intravitreal Injection For Proliferative Diabetic Retinopathy At Perioperative Period

OBJECTIVE:To observe and compare the effects of pars plana vitrectomy(PPV)with or without conbercept intravitreal injection for treatment and surgical procedures of proliferative diabetic retinopathy(PDR).METHODS: In this retrospective research,23 patients(26 eyes)with PDR in our hospital from December 2014 to December 2015 were recruited,and were randomly divided into two groups.11 cases(12 eyes)in control group were received single vitrectomy.In experimental group,12 cases(14 eyes)were injected by drug therapy of 0.5mg/0.05 ml conbercept and received vitrectomy.Record the basic information of these patients(such as gender,age,fasting plasma glucose levels in preoperative,the duration of diabetes and so on)and best-correct visual acuity(BCVA),intraocular pressure(IOP),fundus photography,central macular thickness(CMT)measured by optical coherence tomography(OCT).In the postoperative follow-up of more than half year,the situation of the operations(such as the average operating time,bleeding during operation,iatrogenic hiatal incidence,silicon oilinjection rate and so on)and BCVA、IOP、CMT at each month after surgery and incidence of serious ocular or systemic complications during the follow-up between the two groups were observed and analyzed.RESULTS: The surgical situation of two groups were compared:The average operation time,bleeding during operation of the experimental group were lower than that of the control group:(75.64±18.73)min vs(95.36±14.74)min,14.3% vs 58.3%,P<0.05,they were significantly different.There were 3 eyes(21.4%)occurred iatrogenic retinal breaks in experimental group,and 5 eyes(41.7%)in the control group.There were 4 eyes(28.6%)which underwent silicone oil tamponade in experimental group,and 8eyes(66.7%)in the control group.There were one re-operation eye(7.1%)caused by repeated vitreous hemorrhages or retinal detachment in experimental group,and 2eyes(16.7%)in the control group 。 There was no statistically significant difference between two groups on central foveal thickness before operation((441.92±146.92)VS(452.23±159.62)),but values of experimental group was significantly less than the control group at 4 months after operation:(214.91±30.15)、(318.92±156.17),P<0.05,they were significantly different.There was no statistically significant difference between two groups on BCVA before operation((20.65±26.53)VS(22.29±21.78)),but values of experimental group was significantly more than the control group at4 months after operation:(56.25±22.90)、(38.57±24.72),P<0.05,they were significantly different.The temporary high IOP were occurred in experimental group with1 eye afer conbercept intravitreal injection(27mmHg).The increased IOP restored to the normal level the next day without any treatment.There was no serious systemic complications occurred during the follow-up.CONCLUSION: For those patients with PDR,intravitreal injection of conbercept before vitrectomy can effectively promote the fadeaway of neovascular,minimize the incidence of intraoperative haemorrhage,decrease the operation time,reduce the incidence rates of iatrogenic retinal breaks and silicone oil tamponade,make the operation easier,alleviate macular edema and improve BCVA.