Role of Intravitreal Bevacizumab (Avastin) Injected at the End of Diabetic Vitrectomy in Preventing Postoperative Recurrent Vitreous Hemorrhage

Purpose: The purpose of this study was to evaluate the role of bevacizumab (Avastin), an antivascular endothelial growth factor agent, injected at the end of surgery for preventing postoperative recurrent vitreous hemorrhage in patients undergoing vitrectomy for diabetic eye disease.

Methods: This was a retrospective, comparative, and nonrandomized study on a consecutive series of patients who underwent vitrectomy for diabetic eye disease. Recurrence of postoperative vitreous hemorrhage was compared in patients with and without intravitreal 1.25 mg bevacizumab given at the end of surgery.

Results: During the study period, 58 patients had vitrectomy for diabetic disease. In 33 patients (the control group), no intravitreal bevacizumab was injected at the end of surgery, and in 25 patients (the intervention group) intravitreal bevacizumab 1.25 mg/0.05 mL was injected at the end of surgery. Both groups were matched for the number of patients, age, sex, diagnosis, and status of systemic disease. Recurrent postoperative vitreous hemorrhage was noted in 14 patients in the control group (14 of 33, 42.40%) and in 1 patient in the intervention group (1 of 25, 4.0%). The difference in postoperative vitreous hemorrhage between the 2 groups was statistically significant (P = 0.001). There was no statistical difference in the mean postoperative visual acuity between the 2 groups during the follow-up period (P = 0.410).

Conclusion: Intravitreal injection of 1.25 mg bevacizumab given at the end of vitrectomy appears safe and effective for reducing the incidence of recurrent postoperative vitreous hemorrhage after diabetic vitrectomy. Further randomized studies should be performed to evaluate the potential of this therapy in preventing postoperative recurrent vitreous hemorrhage after diabetic vitrectomy.