To evaluate the effects of bevacizumab pretreatment combined with intravitreal infusion of C₃F₈ 10% on the clearance speed of early postoperative vitreous hemorrhage in diabetic vitrectomy for eyes with active fibrovascular proliferation.

Prospective, nonrandomized, comparative case study.

Sixteen eyes (15 patients) that underwent primary pars plana vitrectomy for active proliferative diabetic retinopathy (PDR) were prospectively enrolled with a follow-up period of six months or more. These cases received an intravitreal injection of bevacizumab (1.25 mg/0.05 ml) one week prior to surgery and intravitreal C₃F₈ 10% infusion during surgery. The severity of intraoperative bleeding, vitreous clear-up time, percentage of prolonged vitreous clear-up (≥ three weeks), and recurrent hemorrhage respectively were compared with those in a control group (24 eyes in 24 patients) that received gas infusion alone.

The severity of intraoperative bleeding was significantly lower in the study group than in the control group. Vitreous clear-up time for the study group and the control group was 7.2 ± 5.6 days and 15.2 ± 11.4 days, respectively (P = .04). Prolonged vitreous clear-up time (≥ three weeks) was observed in one of 16 (6.3%) and nine of 24 (37.5%) of the cases, respectively (P = .03). Early recurrent vitreous hemorrhage rates in the two groups were zero of 16 (0%) and one of 24 (4.2%), respectively (P = .41). Multiple logistic regression analyses showed that bevacizumab pretreatment reduced vitreous clear-up time.

Bevacizumab pretreatment combined with C₃F₈ 10% infusion could be an effective adjunct to vitrectomy in accelerating postoperative vitreous clear-up for eyes with active PDR.