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已发表论文
玻璃体腔注射雷珠单抗与玻璃体冲洗治疗增殖性糖尿病视网膜病变术后玻璃体出血的比较：一项随机对照试验
Authors Chi J, Zhang X, Nie Z, Pan Y, Li W, Hu B
Received 31 July 2025
Accepted for publication 24 December 2025
Published 12 January 2026 Volume 2026:20 557400
DOI https://doi.org/10.2147/DDDT.S557400
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Professor Anastasios Lymperopoulos
Jiaxing Chi,1,* Xiang Zhang,1,* Zetong Nie,1 Yue Pan,1 Wenbo Li,1 Bojie Hu2
1Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, People’s Republic of China; 2NHC Key Laboratory of Hormones and Development, Tianjin Key Laboratory of Metabolic Diseases, Chu Hsien-I Memorial Hospital & Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Bojie Hu, Email bhu07@tmu.edu.cn Wenbo Li, Email wenboli80@163.com
Background: Postoperative vitreous hemorrhage (POVH) after pars plana vitrectomy (PPV) for proliferative diabetic retinopathy (PDR) is a common complication that delays visual recovery. While vitreous lavage (VL) mechanically clears hemorrhages, intravitreal ranibizumab (IVR) targets VEGF-mediated neovascularization. We compared the efficacy and safety of IVR and VL for the management of POVH.
Objective: To compare the visual outcomes, hemorrhage clearance efficiency, and complications between IVR and VL over a 24-week follow-up period.
Methods: In this prospective randomized controlled trial, 26 patients with POVH for PDR were allocated to the VL (n=12) or IVR (n=14) groups. Follow-up evaluations at 1 day, 1 week, 2 weeks, and monthly for up to 6 months included best-corrected visual acuity (BCVA) and complications. Novel metrics that included Visual Acuity Recovery Rate (VARR), Time to 1.0 logMAR-Equivalent Improvement (T1EI), and time to peak BCVA (Tpeak VA) quantified the recovery dynamics.
Results: At 24 weeks, BCVA improvement was comparable between groups (VL: 0.30 LogMAR vs IVR: 0.22 LogMAR, p=0.47). VL achieved immediate BCVA gains in one day (1.99 vs 0.91 LogMAR, p< 0.01), whereas IVR demonstrated progressive improvement after 2 weeks. VARR was higher in VL at 1 day (0.76 vs 0.25, p< 0.001) and 2 weeks (0.84 vs 0.61, p=0.06) but converged by 24 weeks (p=0.86). The complication rates (recurrent hemorrhage and neovascular glaucoma) were similar (p> 0.05).
Conclusion: VL and IVR were both associated with improved visual outcomes in patients with POVH throughout the 24-week follow-up period. The VL group achieved immediate BCVA improvement, and IVR showed a progressive improvement pattern. The VL group showed superior short-term efficiency. IVR showed a trend towards sustained recovery over the 24-week study period. In our study, IVR showed a trend of higher recovery efficiency within the follow-up timeframe. The advert treatment outcomes after the two treatments did not significantly differ. Thus, treatment selection should balance the urgency of visual rehabilitation and patient-specific factors.
Keywords: postoperative vitreous hemorrhage, intravitreal ranibizumab, vitreous lavage
1Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, People’s Republic of China; 2NHC Key Laboratory of Hormones and Development, Tianjin Key Laboratory of Metabolic Diseases, Chu Hsien-I Memorial Hospital & Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Bojie Hu, Email bhu07@tmu.edu.cn Wenbo Li, Email wenboli80@163.com
Background: Postoperative vitreous hemorrhage (POVH) after pars plana vitrectomy (PPV) for proliferative diabetic retinopathy (PDR) is a common complication that delays visual recovery. While vitreous lavage (VL) mechanically clears hemorrhages, intravitreal ranibizumab (IVR) targets VEGF-mediated neovascularization. We compared the efficacy and safety of IVR and VL for the management of POVH.
Objective: To compare the visual outcomes, hemorrhage clearance efficiency, and complications between IVR and VL over a 24-week follow-up period.
Methods: In this prospective randomized controlled trial, 26 patients with POVH for PDR were allocated to the VL (n=12) or IVR (n=14) groups. Follow-up evaluations at 1 day, 1 week, 2 weeks, and monthly for up to 6 months included best-corrected visual acuity (BCVA) and complications. Novel metrics that included Visual Acuity Recovery Rate (VARR), Time to 1.0 logMAR-Equivalent Improvement (T1EI), and time to peak BCVA (Tpeak VA) quantified the recovery dynamics.
Results: At 24 weeks, BCVA improvement was comparable between groups (VL: 0.30 LogMAR vs IVR: 0.22 LogMAR, p=0.47). VL achieved immediate BCVA gains in one day (1.99 vs 0.91 LogMAR, p< 0.01), whereas IVR demonstrated progressive improvement after 2 weeks. VARR was higher in VL at 1 day (0.76 vs 0.25, p< 0.001) and 2 weeks (0.84 vs 0.61, p=0.06) but converged by 24 weeks (p=0.86). The complication rates (recurrent hemorrhage and neovascular glaucoma) were similar (p> 0.05).
Conclusion: VL and IVR were both associated with improved visual outcomes in patients with POVH throughout the 24-week follow-up period. The VL group achieved immediate BCVA improvement, and IVR showed a progressive improvement pattern. The VL group showed superior short-term efficiency. IVR showed a trend towards sustained recovery over the 24-week study period. In our study, IVR showed a trend of higher recovery efficiency within the follow-up timeframe. The advert treatment outcomes after the two treatments did not significantly differ. Thus, treatment selection should balance the urgency of visual rehabilitation and patient-specific factors.
Keywords: postoperative vitreous hemorrhage, intravitreal ranibizumab, vitreous lavage