A network meta-analysis examined the effects of giving anti-VEGF injections around the time of eye surgery for proliferative diabetic retinopathy. The analysis included data from 2,646 eyes across various studies. Researchers looked at how the timing of these injections affected visual acuity and surgical outcomes.
The study found that receiving anti-VEGF injections before surgery significantly improved postoperative best-corrected visual acuity. This improvement was seen regardless of whether the injection was given more than seven days before, three to seven days before, or on the day of surgery. Additionally, the use of these injections reduced the risk of recurrent vitreous hemorrhage and intraoperative bleeding.
Surgical time was also shortened when injections were administered more than seven days before the procedure. There were no significant effects on the need for silicone oil or the risk of recurrent retinal detachment. The overall tolerability of the treatment was considered favorable, though no specific adverse events were reported in the data provided.
Clinicians may select the optimal timing for these injections based on individualized treatment objectives. However, conclusions should be approached with caution due to variability in evidence quality and heterogeneity among the included studies. This analysis suggests potential benefits for surgical planning but does not establish a single standard of care.