Abstract.Purpose: To determine the effect of a triamcinolone-assisted pars plana vitrectomy (PPV) on the visibility of hyaloid during surgery and the postoperative clinical outcome. Methods: Thirty-one patients with proliferative retinal disease [8 with diabetic macular edema (DME), 10 with proliferative diabetic retinopathy (PDR), 13 with proliferative vitreoretinopathy (PVR)] underwent PPV, where the vitreous body was visualized by the intravitreal injection of triamcinolone solution during the operation. The visual acuity, intraocular pressure (IOP), tamponade, corneal pathology, after-cataract, vitreous hemorrhage, and necessity of reoperation, were thereafter examined for at least 3 months after surgery. The anterior chamber laser flare cell meter was used on postoperative day 8 in DME eyes with triamcinolone-assisted PPV and with routine PPV to evaluate the breakdown of the blood–ocular barrier. Results: The vitreous body was clearly seen by means of triamcinolone during surgery, which greatly helped us to perform a posterior hyaloid resection safely and thoroughly. Six of 8 DME eyes, 8 of 10 PDR eyes, and 5 of 13 PVR eyes showed an improvement in their vision postoperatively. No eye except one experienced IOP elevation above 21 mmHg for 7 days. Six eyes had vitreous hemorrhage. The DME eyes which received triamcinolone-assisted PPV showed significantly less breakdown of the blood–ocular barrier than those with routine PPV (Mann–Whitney U-test, P<0.01). Conclusion: Triamcinolone improved the visibility of the hyaloid and the safety of the surgical procedures during PPV and also inhibited the postoperative breakdown of the blood–ocular barrier. Although the long-term effects are still unknown, this method appears potentially useful as an improved treatment for proliferative retinal diseases.

Triamcinolone-assisted Pars Plana Vitrectomy Improves the Surgical Procedures and Decreases the Post-operative Blood-ocular Barrier Breakdown

Purpose: To assess the clinical effects of preoperative, intraoperative, or preoperative combined with intraoperative intravitreal conbercept (IVC) injection in vitrectomy with silicone oil tampona...

Intravitreal Conbercept Injection as an Adjuvant in Vitrectomy with Silicone Oil Infusion for Severe Proliferative Diabetic Retinopathy.

To explore the treatment efficacy of the combination of preoperative intravitreal ranibizumab (IVR) and postoperative intravitreal triamcinolone acetonide (IVTA) in patients undergoing pars plana vitrectomy (PPV) for proliferative diabetic retinopathy (PDR). A retrospective comparative study was performed on 128 eyes of 128 patients who had PDR and underwent PPV. Patients who received a single PPV were assigned to Group A. Those who received PPV with preoperative IVR were assigned to Group B. Patients in Group C underwent PPV combined preoperative IVR and postoperative IVTA. Intraoperative findings, changes in mean best-corrected visual acuity (BCVA) and postoperative adverse events, were retrospectively evaluated at 6-month follow-up. The incidences of iatrogenic breaks, severe intraoperative bleeding, using long-term internal tamponade agents, recurrent vitreous hemorrhage (VH), and duration of surgery were statistically significantly less in Group B and Group C than in Group A. The postoperative BCVA was statistically significantly better in Groups B and Group C than in Group A, respectively, at 1 month after surgery. The mean 3-month postoperative visual acuity was better in Group C. The incidence of high intraocular pressure (IOP) was significantly higher in Group C at the first postoperative week. There were no statistically significant differences in the incidence of exudative retinal detachment and choroidal detachment among the three groups. In patients undergoing PPV for PDR, preoperative IVR significantly reduced the occurrence of intraoperative and postoperative complications, and the combination of preoperative IVR and postoperative IVTA can better improve the postoperative visual outcome.

/pdf/evaluation-of-vitrectomy-combined-preoperative-intravitreal-1o3nb4c62z.pdf

Evaluation of vitrectomy combined preoperative intravitreal ranibizumab and postoperative intravitreal triamcinolone acetonide for proliferative diabetic retinopathy

Purpose. To evaluate the effect of preoperative intravitreal conbercept (IVC) injection on patients with proliferative diabetic retinopathy (PDR). Methods. Medical records of patients who underwent vitrectomy due to complications of PDR were retrospectively reviewed. Patients were grouped as the IVC group and non-IVC group according to preoperative IVC. Preoperative, intraoperative, and postoperative data of both eyes were collected. The main outcome measures were best-corrected visual acuity (BCVA), intraocular pressure (IOP), central retinal thickness (CRT), and incidence of tractional retinal detachment (TRD). Results. A total of 37 cases were included, 16 in the IVC group and 21 in the non-IVC group. Preoperative IVC significantly reduced surgical duration (IVC vs. non-IVC, 88.9 ± 11.9 min vs. 97.8 ± 12.8 min, ). In the vitrectomized eye, no significant difference existed between the IVC group and non-IVC group regarding postoperative BCVA (logMAR, 1.20 ± 0.53 vs. 1.27 ± 0.54, ), IOP (16.5 ± 2.9 mmHg vs. 15.6 ± 3.7 mmHg, ), and CRT (330.1 ± 35.2 μm vs. 319.2 ± 32.5 μm, ). In the fellow eye, 6 cases in the IVC group were diagnosed with TRD during postoperative follow-up, while only 2 cases were diagnosed in the non-IVC group ( ). Conclusion. Preoperative intravitreal injection of conbercept has effectively facilitated vitrectomy in PDR patients, but it potentially promotes tractional retinal detachment in the fellow eye following preoperative injection.

/pdf/preoperative-intravitreal-conbercept-facilitates-vitrectomy-4x0ky24nph.pdf

Preoperative Intravitreal Conbercept Facilitates Vitrectomy in Proliferative Diabetic Retinopathy: Is Attention Required for the Fellow Eye?

Abstract Background To compare the efficacy and safety of preoperative intravitreal injections of ranibizumab and conbercept in Chinese proliferative diabetic retinopathy (PDR) patients. Methods This prospective randomized controlled trial enrolled 90 eyes of 80 patients with PDR. Forty-four eyes of 40 patients that received intravitreal ranibizumab (IVR) injections (0.5 mg/0.05 mL) before vitreous surgeries were assigned to the IVR group. Forty-six eyes of 40 patients that received intravitreal conbercept (IVC) injections (0.5 mg/0.05 mL) before vitreous surgeries were assigned to the IVC group. Intraoperative and postoperative indices were assessed for further comparison between the two groups. Results There were no statistically significant differences in all surgery indices, including intraoperative indices (surgery time, P = 0.225; intraoperative bleeding, P = 0.808; endodiathermy use, P = 0.693; incidence of iatrogenic retinal breaks, P = 0.740; relaxing retinotomy, P = 0.682; retinal reattachment, P = 0.682 and silicone oil tamponade, P = 0.814) and postoperative indices (postoperative vitreous hemorrhage (VH), P = 0.808; neovascular glaucoma (NVG), P = 0.964; recurrent retinal detachment, P = 0.531; postoperative fibrovascular proliferation progression, P = 0.682 and reoperation, P = 0.955) between the two groups. There were no statistically significant differences in best-corrected visual acuity (BCVA) at each follow-up visit ( P = 0.939, 0.669, 0.741 and 0.717, respectively) or in central retinal thickness (CRT) ( P = 0.976, 0.699, 0.551 and 0.686, respectively). As for safety profile, both groups had no ocular or system adverse events during the observation period. Conclusions IVR and IVC as a pretreatment of vitrectomy had similar efficacy and safety profile for Chinese PDR patients. Trial registration: Registered at ClinicalTrials.gov ( NCT05414149 ). 

/pdf/comparison-of-efficacy-and-safety-of-intravitreal-3elwtcx8.pdf

Comparison of efficacy and safety of intravitreal ranibizumab and conbercept before vitrectomy in Chinese proliferative diabetic retinopathy patients: a prospective randomized controlled trial

Introduction. To compare the effect and safety of intravitreal conbercept (IVC), intravitreal ranibizumab (IVR), or intravitreal triamcinolone acetonide (IVTA) injection on 23-gauge (23-G) pars plana vitrectomy (PPV) for proliferative diabetic retinopathy (PDR). Methods. Fifty patients (60 eyes) of varying degrees of PDR were randomly grouped into 3 groups (1 : 1 : 1) ( in each group). The 23-G PPV was performed with intravitreal conbercept or ranibizumab injection 3–7 days before surgery or intravitreal TA injection during surgery. The experiment was randomized controlled, with a noninferiority limit of five letters. Main outcome measures included BCVA, operation time, incidence of iatrogenic retinal breaks, endodiathermy rate, and silicone oil tamponade. Results. At 6 months after surgery, there were no significant differences of BCVA improvements, operation time, incidence of iatrogenic retinal breaks, endodiathermy rate, silicone oil tamponade, vitreous clear-up time, and the incidence of intraoperative bleeding between the IVC and IVR groups (all values ≥ 0.05), but they were significantly different from the IVTA group (all values < 0.05). IOP increases did not show significant differences between the IVC and IVR groups, but both were significantly different with the IVTA group. More patients had higher postoperative IOP in the IVTA group. Conclusions. The intravitreal injection of conbercept, ranibizumab, or TA for PDR had a significant different effect on outcomes of 23-G PPV surgery. Conbercept and ranibizumab can reduce difficulty of the operation, improve the success rate of PPV surgery, and decrease the incidence of postoperative complications.

/pdf/efficacy-and-safety-of-intravitreal-conbercept-ranibizumab-3p91kigtcp.pdf

Efficacy and Safety of Intravitreal Conbercept,Ranibizumab, and Triamcinolone on 23-Gauge Vitrectomy for Patients with Proliferative Diabetic Retinopathy

Potential effect on molecular pathways in different targeted genes in the VEGF family in retina - From the genomic point of view.

Data sets of eQTL loci, correlation analysis, and overlapped genes among gene sets that their expression levels are closely related to genes of Vegf family.

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Efficacy and Safety of Intravitreal Conbercept,Ranibizumab, and Triamcinolone on 23-Gauge Vitrectomy for Patients with Proliferative Diabetic Retinopathy

Potential effect on molecular pathways in different targeted genes in the VEGF family in retina - From the genomic point of view.

Data sets of eQTL loci, correlation analysis, and overlapped genes among gene sets that their expression levels are closely related to genes of Vegf family.