Oftalmol Zh.2015;2:22-26


Results of treatment of post vitrectomy vitreous hemorrhage in patients with proliferative diabetic retinopathy with the use of ranibizumab 

О. О. Putienko, Ali Elhaj, D. M. Pogorelyi 

SI «Filatov Institute of Eye Diseases and Tissue Therapy of the National Academy of Medical Science of Ukraine»; Odessa (Ukraine)

Introduction. Post vitrectomy vitreous hemorrhage is the main cause of failure in vitreous surgery of proliferative diabetic retinopathy, the rate of this complication is 25–75 % of cases. 

Aim of the study. To compare the efficiency of application of the of fluid gas exchange in the treatment of post vitrectomy vitreous hemorrhage in patients with PDRP with and without use of ranibizumab. 

Materials and methods. There were analyzed the results of treatment of post vitrectomy vitreous hemorrhage in 78 patients (78 eye) with proliferative diabetic retinopathy by the fluid gas exchange with the use of 20 % of the gas — air mixture of perfluoropropane. In 28 patients (28 eyes) — main group additionally in the vitreous cavity was introduced 0,5 mg of ranibizumab. 

Results. 2 months after the treatment there were no significant differences (?2=0,73; p=0,39) in achievement of transparency of vitreous cavity with the use of ranibizumab and without it. After 6 months in the group with additional use of ranibizumab transparency of vitreous content was reached in 96,4 % of cases, and without it in 92,0 % (?2 = 0,59; р = 0,44), but the recurrence rate of vitreous hemorrhage in patients without use of ranibizumab was significantly higher– 11 eyes (22,0 %) against 1 (3,6 %) (?2 = 4,68; р = 0,03). 

Conclusion. Fluid gas exchange with 20 % of the gas — air mixture of perfluoropropane with additional introduction in vitreuos cavity of ranibizumab is the most effective treatment of post vitrectomy vitreous hemorrhage in patients of proliferative diabetic retinopathy and can be widely used. 

Key words: proliferative diabetic retinopathy, vitrektomiya, hemophthalmus, ranibizumab.


  1. Nosov SV. Treatment strategy for later post vitrectomy hemophthalmus in diabetic patients. Oftalmokhirurgiia. 2011;3:53–6. In Russian. 
  2. Pogorelyi DN, Putiyenko AA. The results of substitution gas tamponade in the treatment of unabsorbable hemophthalmus after vitrectomy in patients with proliferative diabetic retinopathy. Problemy ekologichnoi ta medichnoi genetiki I klinichnoi imunologii: a collection of papers. 2012;2(110): 484–91. In Russian. 
  3. Putiyenko AA, Pogorelyi DN. Cytokine profile of blood and vitreous fluid of patients with proliferative diabetic retinopathy with hemophthalmia after vitrectomy. Kazanskii med. zhurn. 2013;94(1):26–30. In Russian. 
  4. Sdobnikova SV, Mazurina NK, Stolyarenko GYe, Fedorov FF, Chekmareva IA, Kochetkova EA. Modern approach to the treatment of proliferative diabetic retinopathy. Russkii Med. Zhurnal. 2002;3(3):99–105. In Russian. 
  5. Abbate M, Cravedi P, Iliev I. Prevention and treatment of diabetic retinopathy: evidence from clinical trials and perspectives. Curr Diabetes Rev. 2011;7(3):190–200. 
    Crossref   Pubmed
  6. Entezari M, Ramezani A, Ahmadieh H. Cryotherapy of sclerotomy sites for prevention of late post — vitrectomy diabetic hemorrhage: a randomized clinical trial. Graefes. Arch Clin Exp Ophthalmol. 2010;248:1–19. 
  7. G?nd?z K, Bakri SJ. Management of proliferative diabetic retinopathy. Compr. Ophthalmol Update. 2007;8(5):245–56. 
  8. Koutsandrea CN, Apostolopoulos MN, Chatzoulis DZ et al. Hemostatic effects of SF6 after diabetic vitrectomy for vitreous hemorrhage. Acta Ophthalmol Scand. 2001;79(1):34–8. 
    Crossref   Pubmed
  9. Neely KA, Scroggs KA, McCuen BW. Peripheral retinal cryotherapy for postvitrectomy diabetic vitreous hemorrhage in phakic eyes. Am. J. Ophthalmol. 1998;126(1):82–90. 
  10. Sato T, Morita S, Bando H. Early vitreous hemorrhage after vitrectomy with preoperative intravitreal bevacizumab for proliferative diabetic retinopathy. Middle East Afr J Ophthalmol. 2013;20(1):51–5. 
  11. Steel DH, Connor A, Habib MS. Entry site treatment to prevent late recurrent postoperative vitreous cavity haemorrhage after vitrectomy for proliferative diabetic retinopathy. Br. J. Ophthalmol. 2010;94:1219–25. 
  12. Steel D H, Habib MS, Park S, Hildreth AJ, Owen RI. Entry site neovascularization and vitreous cavity hemorrhage after diabetic vitrectomy. The predictive value of inner sclerostomy site ultrasonography. Ophthalmology. 2008; 115:525–32. 
  13. Tolentino F, Cajita V, Gancayco T, Skates S. Vitreous hemorrhage after closed vitrectomy for proliferative diabetic retinopathy / F. TolentinoOphthalmology. 1989;96(10):1495–500. 
  14. Yang CM, Yeh PT, Yang CH. Intravitreal long — acting gas in the prevention of early postoperative vitreous hemorrhage in diabetic vitrectomy. Ophthalmology. 2007;114(4):710–5.