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題 名 | Bevacizumab Pretreatment in Vitrectomy for Severe Proliferative Diabetic Retinopathy=嚴重增殖性糖尿病視網膜病變於玻璃體切除手術前玻璃體內注射癌思停 |
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作 者 | 王嘉康; | 書刊名 | 中華民國眼科醫學會雜誌 |
卷 期 | 49:4 2010.12[民99.12] |
頁 次 | 頁562-569 |
分類號 | 416.746 |
關鍵詞 | 增殖性糖尿病視網膜病變; 玻璃體切除; 癌思停; Intravitreal injection; Bevacizumab; Proliferative diabetic retinopathy; Vitrectomy; |
語 文 | 英文(English) |
中文摘要 | 目的:本研究目的在於探討嚴重增殖性糖尿病視網膜病變之病患於玻璃體切除手術前玻璃體內注射癌思停。方法:本研究收集了24位嚴重增殖性糖尿病視網膜病變之病患,共28隻眼睛,於玻璃體切除手術前平均9.2日,在玻璃體內注射癌思停(l.25 mg/0.05 ml)。病患共分3組,第一組共8隻眼睛只有接受玻璃體切除手術,第二組共7隻眼睛接受玻璃體切除手術及C3F8氣體灌注,第三組13隻眼睛接受玻璃體切除手術及矽油灌注,追蹤時間至少達3個月。結果:玻璃體切除手術中只有微量出血,術後視網膜皆為回貼狀態,最後一次追蹤時,最佳矯正視力由1.77±0.71增加到0.89±0.51 logMAR(P<0.001)。每一組之視力術後皆增加(P<0.05)。早期術後三個月內玻璃體出血發生於25%、28.6%、及7%在第一、第二、第三組病患。結論:嚴重增殖性糖尿病視網膜病變之病患,於玻璃體切除手術前玻璃體內注射癌思停,可減少手術中出血,但早期術後玻璃體出血仍會發生於部分病人。 |
英文摘要 | Background and Objective: To investigate the short-term clinical outcome of intravitreal bevacizumab (IVB) pretreatment in patients with severe proliferative diabetic retinopathy (PDR) requiring vitrectomy. Materials and Methods: We enrolled 28 eyes of 24 patients with PDR pretreated by IVB (1.25 mg/0.05 ml) for an average of 9.2 days before vitrectomy. The patients were divided into three groups: Group 1-vitrectomy alone (8 eyes), Group 2-vitrectomy with C3F8 tamponade (7 eyes), and Group 3-vitrectomy and silicone oil infusion (13 eyes). Intraoperative bleeding was classified as Grades 1 to 3 from mild to severe degree. The follow-up period was at least 3 months. Results: Minimal bleeding (Grade 1) during vitrectomy and attached retina were discovered after surgery in all patients of Groups 1, 2 and 3. At the end of follow-up, the best-corrected visual acuity improved from 1.77±0.71 to 0.89±0.51 logMAR (p<0.001). Increased visual acuity was found in all groups after surgery (p<0.05). Early postoperative hemorrhage occurring within 3 months was found in 7% of eyes in Group 3, significantly lower than 25% and 28.6% of eyes in Groups 1 and 2 (p<0.01). Conclusion: Bevacizumab as a pre-vitrectomy adjunct in cases with severe PDR causes minor intraoperative bleeding in all groups. However, early postoperative hemorrhage occurs after surgery in some of the patients, and cases with silicone oil tamponade have lower rate of early bleeding than those treated with vitrectomy alone or with long-acting gas infusion. |
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