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Eur J Ophthalmol. 2010 Nov-Dec;20(6):1047-52.

Experience with intravitreal bevacizumab as a preoperative adjunct in 23-G vitrectomy for advanced proliferative diabetic retinopathy.

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Ophthalmology Department, General Hospital Dr. Miguel Silva, and Retina Department, Clínica David-Unidad Oftalmológica, Blvd. García de León 598, Colonia Nueva Chapultepec, Morelia, Michoacán, México.



To evaluate the safety and efficacy of intravitreal injection of bevacizumab before vitrectomy in advanced proliferative diabetic retinopathy.


A randomized clinical trial was performed on 40 eyes of 40 patients. Inclusion criteria were advanced proliferative diabetic retinopathy with tractional retinal detachment and HbA1c <7%. Patients were randomly assigned into 2 groups. Patients in one group had an intravitreal injection (1.25 mg) of bevacizumab 48 hours before 23-G pars plana vitrectomy surgery was performed, whereas the other group did not. Best-corrected visual acuity, intraocular pressure, and fundus photographs were taken prior to surgery 1 week and 3 and 6 months postoperatively.


Effective vitrectomy time was 8.05 minutes in the bevacizumab group vs 16.8 minutes in the non-bevacizumab group. Statistically significant differences were observed in visual acuity at 1 week and 3 and 6 months follow-up between the 2 groups (p<0.05 for each visit). Also, there was less bleeding intraoperatively in the bevacizumab group. Mean final visual acuity in the bevacizumab group was 0.82 logMAR and 2.01 logMAR in the non-bevacizumab group.


Adjuvant intravitreal injection of bevacizumab prior to vitrectomy in diabetic retinopathy with tractional retinal detachment significantly eases the procedure, diminishing intraoperative complications, and leads to a better visual outcome.

[Indexed for MEDLINE]

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