Clinical Observation Of Conbercept In The Treatment Of Diabetic Macular Edema After Pars Plana Vitrectomy

Objective:The purpose of this study was to observe the short-term efficacy and difference of intravitreal injection of Conbercept in the patients with diabetic macular edema after pars plana vitrectomy,to explore the difference of therapeutic effect between different vitreous substitutes(balanced salt solution,silicone oil)and vitreous body,and to analyse the related factors affecting the therapeutic effect of DME after PPV.Methods:This was a retrospective study.We collected the clinical data of DME patients who were in the Ophthalmology Center of the Second Hospital of Jilin University from January 2019 to August 2022.The data of 88 cases 88 eyes were analysed in this study.According to the patients’ vitreous substitutes,the patients were divided into experimental groups:silicone oil group(23 cases,23 eyes)and balanced salt solution group(39 cases,39 eyes),and DME patients without PPV surgery were selected as the control group(26 cases,26 eyes).According to whether the improvement of CMT in the third month after treatment compared with that before treatment was more than 10%,the patients were divided into improvement group(35 cases,35eyes)and non-improvement group(53 cases,53 eyes).All patients were treated with intravitreal injection of Conbercept following the 3+PRN treatment plan.The information collected included the name,sex,age,history of hypertension,the course of diabetes,glycosylated hemoglobin,glomerular filtration rate,axial length of eyes,vitreous substitute after PPV,central macular thickness and best-corrected visual acuity before first intravitreal injection of Conbercept.The silicone oil group received ophthalmology physical examination during the follow-up of 1,2 and 3months after initial intravitreal injection of Conbercept.The balanced salt solution group and the control group received ophthalmology physical examination during the follow-up of 1,2,3,6 and12 months after initial intravitreal injection of Conbercept.The data of BCVA and CMT were collected by the same way and instrument.Data analysis was performed using SPSS 22.0.Results:1 、 During the follow-up period,there was no statistical difference in CMT of the silicone oil group,and the BCVA of the silicone oil group showed statistical difference only in the third month after initial intravitreal injection of Conbercept(P < 0.05).The CMT of the balanced salt solution group showed statistical difference in the first month after initial intravitreal injection of Conbercept(P <0.05).The BCVA of the balanced salt solution group showed statistical difference in the first month and second month after initial intravitreal injection of Conbercept(P < 0.05).The CMT of the control group showed statistical difference in the first month after initial intravitreal injection of Conbercept(P < 0.05).The BCVA of the control group showed statistical difference in the first month after initial intravitreal injection of Conbercept(P < 0.05).2 、 During the follow-up period,there was no statistical difference in CMT between silicone oil group and balanced salt solution group and control group before treatment.At 1 m and 2m after treatment,CMT in silicone oil group was higher than that in the other two groups,with a statistically significant difference(P<0.05).3、Multivariate analysis was carried out with the improvement group as independent variables: the OR of the course of diabetes was 0.978,p<0.05 and the OR of glycosylated hemoglobin was0.352,p < 0.05.Different vitreous substitutes,hypertension,glomerular filtration rate and axial length are not independent factors affecting the treatment of DME,p<0.05.4、During the follow-up period,there was no patients developing endophthalmitis,persistent intraocular hypertension,retinal detachment,vitreous hemorrhage and other major postoperative complications.Conclusion:1、Intravitreal injection of Conbercept can significantly improve the visual function and retinal anatomical structure of DME patients with balanced salt solution(BSS)filled vitreous space and DME patients with vitreous body,and the therapeutic effect is similar.2、Intravitreal injection of Conbercept has no significant effect on the improvement the visual function and retinal anatomical structure of DME patients with silicone oil filled vitreous space.3、Glycosylated hemoglobin and the course of diabetes are independent factors affecting the effect of treatment.4 、Intravitreal injection of Conbercept is a relatively safe treatment for DME.