Evaluation of Vitrectomy in Advanced Proliferative Diabetic Retinopathy
XX Li, YR Jiang Department of Ophthalmology, People's Hospital of Beijing Medical University, Beijing, China
Purpose: To evaluate the improvement of visual acuity for advanced proliferative diabetic retinopathy in 314 eyes with different complications and to confirm the causes of visual loss after vitrectomy.
Methods: Four groups of patients with advanced proliferative diabetic retinopathy in diabetes types 1 and 2 were studied. The groups included patients with vitreous haemorrhage with limited traction retinal detachment.
Results: Postoperative visual acuity of 0.1 were achieved in 59.5% of patients with type 2 diabetes and 66.7% of those with type 1 in the group with vitreous haemorrhage and limited traction retinal detachment; 39.4% of patients with type 2 and 52.6% of those with type 1 in the group with extensive fibrovascular membranes with traction retinal detachment; 31.6% of the combined rhegmatogenous and traction retinal detachment group; and 62.5% of the cataract with vitreous haemorrhage and/or traction retinal detachment group. The major intraoperative complication was iatrogenic breaks. The causes of postoperative visual loss in this study included neovascular glaucoma (2.8% of patients with type 1 diabetes and 0.4% of those with type 2 diabetes in phakia, 25% of type 2 diabetics in aphakia and 4.2% in pseudophakia), retinal detachment, and central retinal artery occlusion.
Conclusion: The majority of eyes with advanced proliferative diabetic retinopathy obtained better visual improvement after vitrectomy and photocoagulation, even in combined rhegmatogenous and traction retinal detachment. Preventing neovascular glaucoma depends on proper management of neovascularisation.
0.1 were achieved in 59.5% of patients with type 2 diabetes and 66.7% of those with type 1 in the group with vitreous haemorrhage and limited traction retinal detachment; 39.4% of patients with type 2 and 52.6% of those with type 1 in the group with extensive fibrovascular membranes with traction retinal detachment; 31.6% of the combined rhegmatogenous and traction retinal detachment group; and 62.5% of the cataract with vitreous haemorrhage and/or traction retinal detachment group. The major intraoperative complication was iatrogenic breaks. The causes of postoperative visual loss in this study included neovascular glaucoma (2.8% of patients with type 1 diabetes and 0.4% of those with type 2 diabetes in phakia, 25% of type 2 diabetics in aphakia and 4.2% in pseudophakia), retinal detachment, and central retinal artery occlusion.
