AIM:To study the efficacy and safety of intravitreal injection ranibizumab(IVR)assisted 25G+ minimally invasive vitreoretinal surgery(VRS)in the treatment of severe proliferative diabetic retinopathy(PDR).

METHODS: Totally 61 patients and 74 eyes were selected with severe PDR from March 2015 to June 2016 in our hospital. According to the principle of voluntary, 37 eyes of 31 cases in the VRS before the IVR treatment was set to the joint group, 37 eyes of 30 cases line pure VRS was set to the VRS group. We compared the vitreous volume, logMAR, mean IOP, macular central retinal thickness and complications between the 2 groups.

RESULTS: The blood rate of glass in the combination group was 8% after 1wk of postoperative which was significantly lower than that of the VRS group 27%(χ²=4.573, P=0.032). The glass volume blood rate of the combined group was 0 after 1mo of postoperative while the VRS was 16%(P=0.033). The blood rate of glass in the combination group was 0 at 3mo of postoperative, and 8% in the VRS group(P=0.238). The LogMAR in the combined group was significantly lower than that in the VRS group(t=2.320, P=0.023). There was no significant difference in the mean IOP between the two groups(t=0.516, P=0.608). The mean macular retinal thickness of the combined group was 298.8±78.3μm which significantly lower than the VRS group 357.1±86.2μm(t=3.045, P=0.003). The combined high intraocular pressure rate of the combined group was 14% which was significantly lower than 32% of the control group(χ²=10.385, P=0.001). The rate of anterior membrane of the retina of the combined group, the rate of recurrent traction and the rate of retinal detachment of the newborn were lower than that of the VRS group, but the difference was not statistically significant(P>0.05).

CONCLUSION: IVR assisted VRS, although there is a certain controversy, but in the appropriate dose, frequency and time to achieve significant efficacy, safety is also high.