| ObjectiveTo observe the clinical effect of intravitreal injection of anti-vascular endothelial growth factor(VEGF)drug conbercept at different time of the microincision vitreoretinal surgery(VRS)in severe proliferative diabetic retinopathy treatment.To explore the indications of the injection of anti-VEGF drug before and during VRS.Methods1.This is a prospective non-randomized controlled clinical study.A total of one hundred and twelve patients(one hundred and twenty eyes)with severe proliferative diabetic retinopathy(PDR)were enrolled.All the patients were divided into preoperative injecting group and control group 1,intraoperative injecting group and control group2.Patients in preoperative injecting group received an intravitreal injection 3-7days before the VRS.Patients in intraoperative injecting group conbercept during the VRS.Two control group patients only received VRS.2.We comparative analysis the postoperative statistical results between two injection groups and their control groups,including postoperative complications,the central retinal thickness(CRT)and the logarithm of the minimum angle of resolution(logMAR)best corrected visual acuity(BCVA)were comparatively analyzed.3.The results were input the SPSS21.0 statistical software.Measurement data were expressed as mean±standard deviation and compared between groups using t test.Enumeration data were compared using ?2 test,continuity correction ?2 test or Fisher''s exact test.Postoperative logMAR BCVA adopted the factor analysis of variance of repeated measurements.Results1.preoperative basic situationThe differences had no statistically significant between the two injection groups and their control groups in age,gender,diabetes duration,history of high blood pressure,stage of PDR,history of retinal laser photocoagulation treatment,logMAR BCVA and intraocular pressure(P>0.05).The average age of two injection groups were respectively(49.27 ± 8.45),(57.32 ± 6.25)years old,the difference was statistically significant(t=-4.00,P<0.05).The average diabetes duration of two groups were respectively(6.58±3.10),(9.96±3.35)years old,the difference was statistically significant(t=-3.85,P<0.05).Proportion of ?and ? PDR were 25/5,18/12 eyes,the difference was statistically significant(t=4.20,P<0.05).2.postoperative complicationsThe incidence of early VH in two injection groups and their own control group were statistically significant,and the incidence in the preoperative injection group were lower(?2=4.71,4.63,P<0.05).3.logMAR BCVA and CRTThe reduction of CRT in two injection groups from 1 week to 1 month were lower than their control groups,and the differences had statistically significant(t=-3.04,-4.14,P<0.05).The logMAR BCVA at different time points a trend of significant change over time(Ftime=177.71,133.20,P<0.05).The logMAR BCVA in two injection groups at 6 months after the VRS were significantly improved than their control group(F=4.86,4.26,P<0.05).Conclusion1.VRS assisted by intraoperative injection of conbercept to treat severe PDR was safe and effective,and it can reduce the incidence of early postoperative VH and the macular edema,improve outcomes for these patients.2.It's better to inject conbercept before VRS for patients with active neovascularization and to choose injecting conbercept during VRS for patients with regressive neovascularization especially accompany with TRD.3.Conbercept can inhibit the formation of new vessels and reduce the macular edema after the operation.Under the principle of voluntary and informed,injection of conbercept assisted VRS for severe PDR is an effective choice of treatment.4.Indications of injection of conbercept at different time of VRS has not been determined.Both preoperative and intraoperative injection have advantages and disadvantages. |
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