Preoperative Injection of Intravitreal Bevacizumab in Dense Diabetic Vitreous Hemorrhage

Purpose: To evaluate the effect of preoperative intravitreal injection of bevacizumab on surgery and on the early postoperative course in diabetic patients undergoing vitrectomy for dense vitreous hemorrhage.

Methods: Thirty-five patients with dense diabetic vitreous hemorrhage were randomly assigned to a group that received 1.25 mg of intravitreal bevacizumab 1 week before vitrectomy (18 patients) or the control group (17 patients). To compare the complexity of two groups, intraoperative complexity score and proliferative diabetic vitreoretinopathy stage were recorded. Intraoperative bleeding, break formation, number of endodiathermy applications, best-corrected visual acuity, anatomical outcome at Month 3 and at final follow-up, and postoperative complications were evaluated.

Results: Mean complexity scores and proliferative diabetic vitreoretinopathy stages of both groups were similar. The mean score of bleeding was 1.05 in the injection group versus 1.76 in the control group (P = 0.35); endodiathermy applications and break formations were 0.44 versus 0.52 (P = 0.68) and 0.22 versus 0.29 (P = 0.60) in the injection and control groups, respectively. Anatomical outcome and visual acuity at Month 3 and at the final follow-up were similar.

Conclusion: The results suggest that intravitreal injection of bevacizumab before vitrectomy for dense diabetic vitreous hemorrhage has no significant effect on facilitation of surgery or on the early postoperative course.