AIM: To explore the curative effect of 25G vitrectomy combined with different anti-vascular endothelial growth factor(VEGF)drugs on patients with proliferative diabetic retinopathy(PDR).

METHODS: PDR patients admitted to the hospital between July 2018 and July 2020 were enrolled as the research subjects, and they all underwent 25G vitrectomy and were administrated anti-VEGF drugs at 7d before surgery. They were divided into ranibizumab group(31 cases, 31 eyes), conbercept group(30 cases, 30 eyes)and aflibercept group(29 cases, 29 eyes)according to different treatment. The aqueous humor was collected before intravitreal injection and during vitrectomy to detect levels of VEGF and pigment epithelial-derived factor(PEDF). The best corrected visual acuity(BCVA)and central macular thickness(CMT)were detected before surgery and at 3 and 6mo after surgery.

RESULTS: After intravitreal injection, level of VEGF in aqueous humor was significantly decreased in all groups(P<0.05), while PEDF level was increased in all groups(P<0.05), but there was no significant difference among the three groups(P>0.05).There was no significant difference in operation time, the occurrence of intraoperative hemorrhage and iatrogenic retinal breaks among the three groups(P>0.05).BCVA among the three groups at 3 and 6mo after surgery was significantly better than that before surgery(P<0.05), and CMT was significantly thinner than that before surgery(P<0.05), but there was no significant difference among the three groups(P>0.05).

CONCLUSION: Intravitreal injection of anti-VEGF drugs before vitrectomy in PDR patients can reduce the expressions of vascular-related factors in aqueous humor. The clinical effect and safety of vitrectomy combined with ranibizumab, conbercept and aflibercept, respectively, are comparable in the treatment of PDR.