Efficacy of pars plana vitrectomy assisted by bevacizumab in the treatment of proliferative diabetic retinopathy：a systematic review

Abstract:

Objective：To evaluate the efficacy pars plana vitrectomy（PPV） assisted by bevacizumab in the treatment of proliferative di－abetic retinopathy（PDR）. Methods：Databases of cochrane library，medline，embase，Chinese biomedical literature database（CBM），VIP，CNKI，Wanfang digital journals were searched for randomized controlled trials（RCTs） or comparative study of bevacizumab ad－juvant PPV in treatment of PDR. Quality of enrolled literatures was assessed and software of Rev Man 5.1 was employed to conduct Meta analysis. Results：A total of 8 RCTs were included，including 319 eyes（experimental group：167 eyes，control group：152 eyes）. Meta analysis results suggested that the experimental group had better visual acuity recovery（OR=-0.37，95%CI=-0.45 to -0.30，P=0.000） and shorter mean operation time than controls（MD=-17.37，95%CI=-29.32 to -5.42，P=0.004）. Moreover，cases having less intraoperative bleeding（OR=0.06，95%CI=0.02 to 0.18，P=0.000），endodiathermy frequency（OR=0.07，95%CI=0.02 to 0.22），P=0.000），iatrogenic retinal tear（MD=-17.37，95%CI=-29.32 to -5.42，P=0.004） and recurrent vitreous hemorrhage（OR=0.36，95%CI=0.20 to 0.64，P=0.000） were fewer in experiment group than in control group. There was no significant differences in retinal detach－ment（OR=0.35，95%CI=0.12 to 1.01，P=0.050） and intraocular pressure（OR=0.48，95%CI=0.18 to 1.23，P=0.130） between the two groups. Conclusions：Bevacizumab assisted vitrectomy for PDR is more effective than single PPV treatment and it can reduce postop－erative complications.