Clinical efficacy of intravitreal aflibercept injection versus vitrectomy with panretinal photocoagulation for patients with proliferative diabetic retinopathy

Abstract

Background: In the current literature, it is still controversial whether intravitreal aflibercept injection can provide better vision restoration compared with vitrectomy with panretinal photocoagulation (PRP) for proliferative diabetic retinopathy (PDR) patients. Given that there is no high-quality meta-analysis or review to incorporate existing evidence, the purpose of this study is to systematically review the level I evidence in the literature to ascertain whether intravitreal aflibercept injection can provide better vision restoration compared with vitrectomy with PRP for PDR patients. Methods: The systematic literature review is structured to adhere to PRISMA guidelines (Preferred Reporting Items for Systematic Reviews and Meta-analyses), which include requirements deemed essential for the transparent reporting of results. A systematic search will be performed in Web of Science, Embase, Scopus, Science Direct, Cochrane Library up to and inclusive of March 19, 2021. The method of data extraction will follow the approach outlined by the Cochrane Handbook for Systematic Reviews of Interventions. The primary outcome is change in best-corrected visual acuity. The secondary outcomes are change in area of neovascularization and change in area of retinal nonperfusion. Where disagreement occurs, this will be resolved through discussion. All outcomes are pooled on random-effect model. A P value of < .05 is considered to be statistically significant. Results: The results of our review will be reported strictly following the PRISMA criteria. Conclusions: The hypothesis of the study was that visual acuity recovery would be faster with vitrectomy because the blood is mechanically cleared during surgery. Registration number: 10.17605/OSF.IO/NCAXW.

Therapeutic effect of cataract surgery with simultaneous intravitreal injection of aflibercept on diabetic macular edema: An observational study

“…reduction of the vascular endothelial growth factor (VEGF) level, through either intravitreal injection (IVI) of anti-VEGF drug or retinal photocoagulation, and 2. inflammation control, primarily through IVI of steroids and its derivatives. [5][6][7][8][9] Previous studies revealed that inflammation associated with cataract surgery may exacerbate the breakdown of the bloodretina barrier (BRB), which could worsen DR and DME. [10][11][12] The Diabetic Retinopathy Clinical Research Network also implicated that cataract surgery may increase the risk of developing DME and worsening visual acuity (VA) within 16 weeks of cataract extraction.…”