Complications, Compliance, and 3-Year Outcomes After Endolaserless Vitrectomy With Aflibercept Monotherapy for Proliferative Diabetic Retinopathy-Related Vitreous Hemorrhage

Ophthalmic Surg Lasers Imaging Retina. 2023 Feb;54(2):89-96. doi: 10.3928/23258160-20221216-02. Epub 2023 Feb 1.

Abstract

Background and objective: To report the 3-year outcomes for endolaserless vitrectomy with intravitreal aflibercept injection (IAI) monotherapy for proliferative diabetic retinopathy (PDR)-related vitreous hemorrhage (VH).

Materials and method: Eyes underwent endolaserless vitrectomy and received one preoperative and intraoperative IAI followed by randomization to a q8week or q16week IAI group. Additional IAI was administered as needed.

Results: 31/40 eyes were randomized (14 q8week eyes, 17 q16week eyes). Through 152 weeks, q8week and q16week eyes received 18.6 and 12.1 IAI, respectively. Q8week eyes observed a 34 letter visual acuity (VA) increase (P = 0.003) compared to a 27 letter increase in the q16week group (P = 0.013).

Conclusions: Endolaserless vitrectomy with aflibercept monotherapy for PDR-related VH provides significant long-term visual gains. Frequent IAI is required for fewer proliferative consequences. [Ophthalmic Surg Lasers Imaging Retina 2023;54:89-96.].

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Angiogenesis Inhibitors
  • Antibodies, Monoclonal, Humanized
  • Bevacizumab / therapeutic use
  • Diabetes Mellitus* / drug therapy
  • Diabetes Mellitus* / surgery
  • Diabetic Retinopathy* / complications
  • Diabetic Retinopathy* / diagnosis
  • Diabetic Retinopathy* / drug therapy
  • Humans
  • Intravitreal Injections
  • Vascular Endothelial Growth Factor A
  • Vitrectomy / adverse effects
  • Vitreous Hemorrhage / diagnosis
  • Vitreous Hemorrhage / etiology
  • Vitreous Hemorrhage / surgery

Substances

  • aflibercept
  • Angiogenesis Inhibitors
  • Antibodies, Monoclonal, Humanized
  • Bevacizumab
  • Vascular Endothelial Growth Factor A