The Therapeutic Effect Of Vitrectomy Assisted By Conbercept For Severe Proliferative Diabetic Retinopathy

Objective Observation and analysis of preoperative intravitreal injection of conbercept assisted vitrectomy for PDR effects and complications.Methods A retrospective analysis of 79 eyes of 77 patients with severe PDR who received vitrectomy from August 2014 to May 2015 in the Chongqing Medical University Affiliated Hospital of Ophthalmology,including 42 eyes undergo intravitreal injection of conbercept and Pars plana vitrectomy(injection group),37 eyes undergo Pars plana vitrectomy only(control group).The conbercept was performed on the eyes 3-7 days before Pars plana vitrectomy in the injection group,the control group is only received Pars plana vitrectomy, All patients underwent the surgery of extensive retinal laser photocoagulation.Operative duration,postoperative bleeding, incidence of iatrogenic retinal holes, the use of tamponade,best corrected visual acuity(BCVA)(LogMAR), postoperative complications were compared between the two groups.Results 1.the operative duration: the average operation time for injection group was 70.90±27.42,control group in average operation timewas 95.76±26.15, compared between two groups of operation time injection group was obviously shorter than the control group, the difference was statistically significant.2.Intraoperative hemorrhage: injection group was 2 cases of intraoperative hemorrhage, the proportion is 4.76% of injection group, intraoperative hemorrhage cases for control group were 10,accounted for 27.03% of the control group, operation difference was statistically significant. 3.Iatrogenic retinal hiatal: injection group in the number of cases were 3, the ratio 7.14% of injection group, the cases of 8in control group, accounted for 21.62% of the control group,operation difference was statistically significant. 4.Intraocular implants usage:intraocular silicone oil filled cases for injection group were 5, the proportion 11.90% of injection group, the cases of intraocular filling inert gas were 12,the proportion is 28.57% of injection group. The control group were the number of cases of 19 for intraocular silicone oil filled, accounted for 51.35% of the control group, filled with inert gas were 11 cases, control group operation ratio of 29.73%. Silicone oil usage similar between the two groups was statistically significant, but there was no statistically significant difference gas utilization.5.The postoperative best corrected visual acuity:postoperative 3 months BCVA for injection group was 0.71±0.50, with preoperative visual acuity 1.72±0.49, the visual was obviously improved in postoperative, compared with the control group after 3 months BCVA was1.28±0.53,with preoperative visual acuity 1.71±0.46, postoperative visualacuity improved injection group compared between the 2 groups, the difference was statistically significant.6.Postoperative complications:included postoperative endophthalmitis, vitreous hemorrhage again, high intraocular pressure, neovascular glaucoma, such as injection group vitreous hemorrhage again was 1 case, the proportion is2.38% of injection group, control group were 7 cases for vitreous hemorrhage again, the proportion is 18.91% of control group, the difference was statistically significant.Conclusion conbercept joint vitrectomy used in the treatment of severe proliferation diabetic retinopathy can effectively shorten the operation time,reduce intraoperative bleeding and the risk of iatrogenic retinal hiatal,improve visual acuity, help to improve treatment efficiency of severe proliferation stage of diabetic retinopathy with vitrectomy, reduce the operation difficulty, etc.