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    Prior vitrectomy does not affect DME therapy with ranibizumab, laser

    In the long term, both vitrectomized and nonvitrectomized groups showed similar results

    Take-home message: Analysis of eyes with and without prior vitrectomy from DRCR Protocol I showed similar results when treated with ranibizumab with prompt or deferred laser.

    Reviewed by John A. Wells III, MD, FACS

    West Columbia, SC—Eyes with diabetic macular edema (DME) and prior vitrectomy treated with anti-vascular endothelial growth factor (VEGF) agents appear to respond similarly to eyes with DME and no prior vitrectomy, said John A. Wells III, MD, FACS.

    Dr. Wells focused on a comparison of visual and optical coherence tomography (OCT) outcomes in eyes with and without previous vitrectomy that had received ranibizumab (Lucentis, Genentech) and prompt or deferred laser treatment for DME. The research focused on anatomic and clinical outcomes from the Laser Ranibizumab Triamcinolone Trial for DME (Protocol I) within the Diabetic Retinopathy Clinical Research (DRCR) Network.

    Other DRCR researchers have showed that treatment with ranibizumab, with immediate or deferred for at least 6 months laser treatment, was more effective than laser treatment alone for at least 2 years in patients with center-involved DME, Dr. Wells said.

    Additionally, the vision benefits at year 1 appear to be sustained through at least a 5-year follow-up.

    However, it has been suggested that in eyes with previous vitrectomy, anti-VEGF agents could have a shorter duration of action because of rapid clearance of the drug.

    “There’s a lack of data to support this except in a small series of eyes treated with bevacizumab,” said Dr. Wells, in practice in Palmetto Retina, West Columbia, SC.

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