Efficacy Comparison Between Injection Of Intravitreal Ranibizumab And Triamcinolone As A Preoperative Adjunct Before Vitrectomy Surgery For Proliferative Diabetic Retinopathy

ObjectiveTo observe the differences between intravitreal injection of ranibizumab(Lucentis) and triamcinolone(TA) before vitrectomy surgery in the treatment of proliferative diabetic retinopathy(PDR). MethodsA total of 61 patients(78 eyes) with PDR diagnosed in our clinic from March 2014 to September 2015 were enrolled and divided into Lucentis group(33 patients, 42 eyes) and TA group(28 patients, 36 eyes). Lucentis group patients received an intravitreal injection of Lucentis before pars plana vitrectomy(PPV), TA group patients received an intravitreal injection of TA. The average operation time, the use of filler and electric coagulation during the surgery, the change of best corrected visual acuity(BCVA), postoperative bleeding, intra-ocular pressure(IOP) and central macular thickness(CMT) were comparatively analyzed between the two groups. Series comparisons were made using a Student's t-test, and chi-square statistics or Fisher's exact test as appropriate for categorical variables. A P<0.05 was considered significant. ResultsThe operation time in the Lucentis group was(46.95±18.16)min, while in the TA group was(66.42±17.76)min, the difference was statistically significant(t=?4.767, P=0.000). Three eyes needed electric coagulation in Lucentis group, eleven eyes in TA group, and the difference was statistically significant(2?=7.215, P=0.009). The mean 3 months after surgery logMAR BCVA of Lucentis group is(0.88±0.50), which preoperative BCVA is(1.83±0.76), the improvement of postoperative BCVA is significant(t=6.557,P=0.000). In the TA group, the mean 3 months after surgery logMAR BCVA is(1.04±0.68), which preoperative BCVA is(1.87±0.94), the improvement of postoperative BCVA is significant(t=5.837, P=0.000). But the improvements in two groups have no significant difference(Z=?810, P=0.418);In the follow up, all the retina is attached. The differences of oil silicone use, postoperative bleeding, IOP and CMT between two group were not statistically significant(P>0.05). Conclusion1. For proliferative diabetic retinopathy, preoperative intravitreal injection of Lucentis can more significantly decrease intraoperative hemorrhage, reduce electric coagulation, and shorten the operation time, improve the effects of PPV in PDR patients.2. The intravitreal injection of Lucentis and TA before the vitrectomy surgery for PDR are both effective. The long-term complications and prognosis of the pars plana vitrectomy for PDR between the Lucentis group and TA group have no obvious difference.