EFFICACY OF 23G PARS PLANA VITRECTOMY WITH ANTI-VEGF THERAPY FOR SEVERE PROLIFERATIVE DIABETIC RETINOPATHY IN ATHLETES: A CLINICAL ASSESSMENT

Abstract

Objective: This study evaluates the efficacy of preoperative intravitreal anti-vascular endothelium growth factor (anti-VEGF) injections combined with 23G pars plana vitrectomy (PPV) in athletes with severe proliferative diabetic retinopathy (PDR), aiming to assess its impact on surgical outcomes and postoperative visual acuity. Methods: Conducted at Tangshan Eye Hospital from February 2020 to June 2021, this prospective controlled study involved 35 cases (40 eyes) of severe PDR in athletes treated with PPV. Patients were categorized based on the stage of PDR (active or degenerative) and treatment type (PPV with or without anti-VEGF). We compared surgical duration, incidence of intraoperative complications (such as coagulation and iatrogenic retinal breaks), postoperative hemorrhage, and best corrected visual acuity (BCVA) at three months post-surgery. Results: No significant difference in BCVA improvement was observed across all groups at three months (P=0.190). However, groups receiving preoperative anti-VEGF (active and degenerative stages) showed statistically significant reductions in postoperative hemorrhage and shorter operative times compared to those without anti-VEGF, particularly in the active stage group. Notably, the active stage group treated with anti-VEGF also exhibited a lower rate of intraoperative complications. Conclusion: Preoperative anti-VEGF treatment is beneficial for athletes undergoing PPV for active stage PDR, reducing surgical difficulties and complication rates. However, for degenerative stage PDR, preoperative anti-VEGF does not appear to reduce complication rates and may increase operational challenges and costs. This study highlights the need for tailored preoperative strategies based on the specific stage of PDR in athletes, optimizing surgical outcomes and postoperative recovery. The cost and risk-benefit ratio of anti-VEGF treatment should be carefully considered in treatment planning.