Perioperative Use of Bevacizumab in Vitrectomy for Proliferative Diabetic Retinopathy: A Literature review

Purpose: To review the effectiveness and safety of perioperative injection of bevacizumab in vitrectomy for proliferative diabetic retinopathy (PDR) Methods: A literature search of all English articles from the Medline and Scopus databases was performed. Original articles, case reports and letters were included. Results: Nineteen, 3 and 5 studies reported preoperative, intraoperative and postoperative intravitreal injection of bevacizumab, respectively. There are good evidences that preoperative injection of bevacizumab induces the regression of new vessels, facilitates the surgery and may reduce the incidence of postoperative vitreous hemorrhage in selected eyes. Also, it may decrease the vitreous clear up time for postoperative vitreous hemorrhage. However, the risk of development or progression of tractional retinal detachment (TRD) should be considered. Postoperative complications like the neovascular glaucoma and nonclearing vitreous hemorrhage may be properly managed by intraocular bevacizumab injection. Conclusion: Preoperative intravitreal bevacizumab (IVB) seems to be effective and relatively safe for surgical facility with variable effects on postoperative hemorrhage. Postoperative intravitreal injection may be effective for the treatment of postoperative complications.