The experience to use a modified en bloc excision technique in vitrectomy for diabetic traction retinal detachment.

Modified en bloc excision is a technique in which all posterior hyaloid is excised except the portions essential for membrane dissection. Then, bimanual dissection techniques allow excision of retained fibrovascular membrane "en bloc" with hyaloid. In a consecutive series of 16 eyes with diabetic traction retinal detachment treated with this technique, visual acuity of 5/200 or better was obtained in 11 (69%) of the cases, and complete macula reattachment was noted in 14 (87%) of 16 eyes. The final visual acuity was improved in 12 (75%) cases. While this surgical technique allows a higher rate of anatomic success and less postoperative morbidity, visual results remain limited by irreversible alteration in retinal function.