ROLE OF ADJUNCTIVE USE OF INTRAVITREAL BEVACIZUMAB FOR SEVERE PROLIFERATIVE DIABETIC RETINOPATHY BEFORE VITRECTOMY

The purpose of this work to assess the results and to determine the appropriate timing of pars plana vitrectomy after pretreatment with intravitreal Bevacizumab for proliferative diabetic retinopathy. This prospective study was conducted in Eye Unit I, Services Hospital/ SIMS Lahore for the duration of 6 months from October 2008-March 2009. Twenty one eyes of fifteen patients suffering from problem of proliferative diabetic retinopathy (PDR) were included in this study. These consisted of male as well as female patients with age range of 40-65 years. A written informed consent was obtained from all patients. All of them were completely evaluated in Eye OPD, Lahore. Fluorescein angiography was advised to every patient. An intravitreal injection of 1.25 mg / 0.05 ml was given with complete antiseptic technique, three days to two weeks prior to pars plana vitrectomy. Mini- mum bleeding during pars plana vitrectomy of fibrovascular membrane and less post-operative complications were observed. The complications were less in cases having intravitreal injection of bevacizumab before surgery for shorter duration as compared to longer period. Adjunctive use of intravitreal bevacizumab for severe proliferative diabetic retinopathy before pars plana vitrectomy is very effective. The appropriate timing of vitrectomy after intravitreal bevacizumab need to be further evaluated.