open access
Outcomes of vitrectomy in severe complications of proliferative diabetic retinopathy
open access
Abstract
INTRODUCTION. The aim of our study is to describe the anatomical and functional results of pars plana vitrectomy (PPV) among diabetic patients treated due to tractional retinal detachment (TRD) or non-clearing vitreous haemorrhage (VH).
MATERIALS AND METHODS. A retrospective analysis was made of clinical data of 45 eyes treated with 23G PPV for TRD (17 eyes) or VH (28 eyes). Preoperative and final visual outcomes and postoperative complications were recorded. The mean follow-up period was 12 months.
RESULTS. The postoperative visual acuity (VA) improved significantly in 60% of eyes, but remained unchanged or was worse in 40%. Improvement of VA was more pronounced in the VH group. PPV was performed with silicone oil tamponade in 66.5%, air tamponade in 29%, and gas tamponade in 4.5%. Postoperative complications included: retinal re-detachment (seven eyes), secondary glaucoma (nine eyes), and recurrent VH (two eyes).
CONCLUSIONS. PPV is an effective treatment method of complications of severe proliferative diabetic retinopathy inter alia the TRD and VH. Because surgical management of TRD and VH is demanding, anatomical and functional results are limited by complications.
Abstract
INTRODUCTION. The aim of our study is to describe the anatomical and functional results of pars plana vitrectomy (PPV) among diabetic patients treated due to tractional retinal detachment (TRD) or non-clearing vitreous haemorrhage (VH).
MATERIALS AND METHODS. A retrospective analysis was made of clinical data of 45 eyes treated with 23G PPV for TRD (17 eyes) or VH (28 eyes). Preoperative and final visual outcomes and postoperative complications were recorded. The mean follow-up period was 12 months.
RESULTS. The postoperative visual acuity (VA) improved significantly in 60% of eyes, but remained unchanged or was worse in 40%. Improvement of VA was more pronounced in the VH group. PPV was performed with silicone oil tamponade in 66.5%, air tamponade in 29%, and gas tamponade in 4.5%. Postoperative complications included: retinal re-detachment (seven eyes), secondary glaucoma (nine eyes), and recurrent VH (two eyes).
CONCLUSIONS. PPV is an effective treatment method of complications of severe proliferative diabetic retinopathy inter alia the TRD and VH. Because surgical management of TRD and VH is demanding, anatomical and functional results are limited by complications.
Keywords
proliferative diabetic retinopathy, vitreous haemorrhage, tractional retinal detachment, vitrectomy
About this articleTitle
Outcomes of vitrectomy in severe complications of proliferative diabetic retinopathy
Journal
Issue
Article type
Original paper
Pages
17-21
Published online
2017-03-22
Page views
659
Article views/downloads
1642
DOI
Bibliographic record
Ophthalmol J 2017;2(1):17-21.
Keywords
proliferative diabetic retinopathy
vitreous haemorrhage
tractional retinal detachment
vitrectomy
Authors
Dorota Borowicz
Dominika Nowakowska
Edyta Koman
Katarzyna Nowomiejska
Robert Rejdak
References (10)- Ho T, Smiddy WE, Flynn HW. Vitrectomy in the management of diabetic eye disease. Surv Ophthalmol. 1992; 37(3): 190–202.
- Machemer R, Buettner H, Parel JM, et al. Vitrectomy: a pars plana approach. Trans Am Acad Ophthalmol Otolaryngol. 1971; 75(4): 813–820.
- O'Malley C, Heintz RM. Vitrectomy via the pars plana--a new instrument system. Trans Pac Coast Otoophthalmol Soc Annu Meet. 1972; 53: 121–137.
- Heimann K, Dahl B, Dimopoulos S, et al. Pars plana vitrectomy and silicone oil injection in proliferative diabetic retinopathy. Graefes Arch Clin Exp Ophthalmol. 1989; 227(2): 152–156.
- Newman DK. Surgical management of the late complications of proliferative diabetic retinopathy. Eye (Lond). 2010; 24(3): 441–449.
- Oshima Y, Shima C, Wakabayashi T, et al. Microincision vitrectomy surgery and intravitreal bevacizumab as a surgical adjunct to treat diabetic traction retinal detachment. Ophthalmology. 2009; 116(5): 927–938.
- Dikopf MS, Patel KH, Setlur VJ, et al. Surgical outcomes of 25-gauge pars plana vitrectomy for diabetic tractional retinal detachment. Eye (Lond). 2015; 29(9): 1213–1219.
- Sharma T, Fong A, Lai TY, et al. Surgical treatment for diabetic vitreoretinal diseases: a review. Clin Exp Ophthalmol. 2016; 44(4): 340–354.
- Abunajma MA, Al-Dhibi H, Abboud EB, et al. The outcomes and prognostic factors of vitrectomy in chronic diabetic traction macular detachment. Clin Ophthalmol. 2016; 10: 1653–1661.
- Sternfeld A, Axer-Siegel R, Stiebel-Kalish H, et al. Advantages of diabetic tractional retinal detachment repair. Clin Ophthalmol. 2015; 9: 1989–1994.