Clinical Observation Of Intravitreal Anti-VEGF Drugs Injection Before Vitrectomy In Patients With PDR

Objective:To investigate the clinical effect of therapy that combines vitrectomy with intravitreal anti-VEGF drug injection in patients with proliferative diabetic retinopathy.Methods:Fifty eyes of 43 patients with proliferative diabetic retinopathy(PDR)diagnosed from August 2018 to May 2020 in Anhui Provincial Hospital were selected and treated with 23 G vitrectomy.50 eyes were divided into two groups,17 patients(20eyes)in the injection group and 30 patients(26 eyes)in the control group.Anti-VEGF drugs were injected into the vitreous 3 to 7 days before 23 G vitrectomy in the injection group,while 23 G vitrectomy was performed directly after admission in the control group.The operation time,intraoperative and postoperative complications and the visual acuity of the two groups were observed and analyzed.Results: Intraoperative hemorrhage and the use of electrocoagulation in the injection group were significantly less than those in the control group,the incidence of recurrent vitreous hemorrhage in the injection group was significantly lower than those in the control group,the incidence of ocular hypertension in the injection group was significantly lower than that in the control group.The above indicators showed statistically significant differences between the two groups(?2 =3.955,(49)<0.05;?2=5.426,(49)<0.05;?2 =4.084,(49)<0.05).However,there was no significant difference in operative time between the two groups(t=0.248,(49)>0.05).What’s more,The use of intraocular implants in the injection group was less than that in the control group,but there was no significant difference in the number of eyes between the two groups(?2=0.013,(49)>0.05).The 50 patients were followed up for half a year,and the visual acuity after operation was better than that before operation,and the difference was significant(?2 =26.582,(49)<0.05).The rate of vision improvement during the 6 months after the 23 G vitrectomy of the injection group was higher than that of the control group,but there was no significant difference between the two groups((49)>0.05).Conclusion:Intravitreal anti-VEGF drug injection before 23 G vitrectomy in PDR patients can reduce the occurrence of intraoperative bleeding,the use rate of intraoperative electrocoagulation,and the occurrence of postoperative complications,these include recurrent vitreous hemorrhage and elevated intraocular pressure,which in turn reduce the risk of reoperation.However,there was no significant difference between the two groups in the use of intraoperative tamponade,the operation time and the improvement of postoperative visual acuity.