Literature DB >> 22241020

Surgical and visual outcome following 20-gauge vitrectomy in proliferative diabetic retinopathy over a 10-year period, evidence for change in practice.

B Gupta1, R Wong, S Sivaprasad, T H Williamson.   

Abstract

INTRODUCTION: The study reports 10-year anatomical and visual outcome in patients who underwent pars plana vitrectomy (PPV) for complications due to proliferative diabetic retinopathy (PDR).
METHODS: Retrospective analysis of patients undergoing 20 G PPV from January 1999 to May 2010 for tractional retinal detachment (TRD) and non-clearing vitreous hemorrhage (NCVH) secondary to PDR recorded prospectively on an electronic patient record. The primary aim was to study anatomical success and eyes with visual acuity (VA) of ≤ 0.3 logMAR at last follow-up.
RESULTS: There were 346 eyes of 249 patients with mean age of 55.63 years and follow-up of 1.44 years. In all, 95.3% of eyes had a flat retina at final follow-up. Overall 136/346 (39.4%) eyes had final VA of logMAR ≤ 0.3 (Snellen 6/12) and 129 (37.3%) had logMAR ≥ 1.0 (Snellen 6/60). In all, 50/181 (27.6%) eyes with TRD and 84/165 (50.9%) with NCVH achieved final VA of ≤ 0.3 logMAR (Snellen 6/12). A total of 218 (63.1%) showed ≥ 0.3 logMAR improvement from baseline to last follow-up. Both preoperative VA and final postoperative (post-op) VA (P<0.001) improved significantly with each year from 1999 to 2010. The commonest peroperative complication was iatrogenic retinal tear formation (28.4%). This was a risk factor for the development of post-op retinal detachment, odds ratio: 3.90 (95% confidence interval: 1.91-7.97, P = 0.0002). Silicone oil was used in 5.2% of patients at the primary procedure. In all, 9.2% required removal of non clearing post vitrectomy hemorrhage.
CONCLUSIONS: Outcomes from vitreoretinal surgery for complications of diabetic retinopathy have improved. In addition, the visual outcome after diabetic vitrectomy steadily improved over the 10-year period, which may in part be due to the move to operate on patients with better vision.

Entities:  

Mesh:

Year:  2012        PMID: 22241020      PMCID: PMC3325568          DOI: 10.1038/eye.2011.348

Source DB:  PubMed          Journal:  Eye (Lond)        ISSN: 0950-222X            Impact factor:   3.775


  31 in total

1.  Early vitrectomy for severe proliferative diabetic retinopathy in eyes with useful vision. Results of a randomized trial--Diabetic Retinopathy Vitrectomy Study Report 3. The Diabetic Retinopathy Vitrectomy Study Research Group.

Authors: 
Journal:  Ophthalmology       Date:  1988-10       Impact factor: 12.079

2.  Early vitrectomy for severe proliferative diabetic retinopathy in eyes with useful vision. Clinical application of results of a randomized trial--Diabetic Retinopathy Vitrectomy Study Report 4. The Diabetic Retinopathy Vitrectomy Study Research Group.

Authors: 
Journal:  Ophthalmology       Date:  1988-10       Impact factor: 12.079

3.  Pars plana vitrectomy. Treatment for tractional macula detachment secondary to proliferative diabetic retinopathy.

Authors:  S A Miller; J B Butler; F L Myers; G H Bresnick
Journal:  Arch Ophthalmol       Date:  1980-04

4.  Early vitrectomy for severe vitreous hemorrhage in diabetic retinopathy. Two-year results of a randomized trial. Diabetic Retinopathy Vitrectomy Study report 2. The Diabetic Retinopathy Vitrectomy Study Research Group.

Authors: 
Journal:  Arch Ophthalmol       Date:  1985-11

5.  The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus.

Authors:  D M Nathan; S Genuth; J Lachin; P Cleary; O Crofford; M Davis; L Rand; C Siebert
Journal:  N Engl J Med       Date:  1993-09-30       Impact factor: 91.245

6.  Pars plana vitrectomy in the Early Treatment Diabetic Retinopathy Study. ETDRS report number 17. The Early Treatment Diabetic Retinopathy Study Research Group.

Authors:  H W Flynn; E Y Chew; B D Simons; F B Barton; N A Remaley; F L Ferris
Journal:  Ophthalmology       Date:  1992-09       Impact factor: 12.079

7.  Ten years after the Diabetic Retinopathy Study.

Authors:  S L Fine; A Patz
Journal:  Ophthalmology       Date:  1987-07       Impact factor: 12.079

8.  Incidence of cataract extraction after diabetic vitrectomy.

Authors:  William E Smiddy; William Feuer
Journal:  Retina       Date:  2004-08       Impact factor: 4.256

9.  Results of vitrectomy for diabetic traction retinal detachments using the en bloc excision technique.

Authors:  D F Williams; G A Williams; A Hartz; W F Mieler; G W Abrams; T M Aaberg
Journal:  Ophthalmology       Date:  1989-06       Impact factor: 12.079

Review 10.  The Wisconsin epidemiological study of diabetic retinopathy: a review.

Authors:  R Klein; B E Klein; S E Moss
Journal:  Diabetes Metab Rev       Date:  1989-11
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  12 in total

1.  Beneficial visual outcome of vitrectomy and delamination surgery for tractional complications of diabetic retinopathy in a cohort of black patients.

Authors:  Jason Ho; Tom H Williamson; Roger S Wong; D Alistair H Laidlaw
Journal:  Eye (Lond)       Date:  2019-07-03       Impact factor: 3.775

2.  Preoperative laser reduces silicone oil use in primary diabetic vitrectomy.

Authors:  Wen-Bin Zheng; Xiao-Hu Ding; Kun-Bei Lai; Ji-Zhu Li; Yu-Qing Wu; Yuan Ma; Zi-Ye Chen; Shi-Da Chen; Sai-Nan Xiao; Bing-Qian Liu; Ying Lin; Tao Li
Journal:  Int J Ophthalmol       Date:  2022-04-18       Impact factor: 1.779

3.  Effect of Intravitreous Aflibercept vs Vitrectomy With Panretinal Photocoagulation on Visual Acuity in Patients With Vitreous Hemorrhage From Proliferative Diabetic Retinopathy: A Randomized Clinical Trial.

Authors:  Andrew N Antoszyk; Adam R Glassman; Wesley T Beaulieu; Lee M Jampol; Chirag D Jhaveri; Omar S Punjabi; Hani Salehi-Had; John A Wells; Maureen G Maguire; Cynthia R Stockdale; Daniel F Martin; Jennifer K Sun
Journal:  JAMA       Date:  2020-12-15       Impact factor: 56.272

Review 4.  Surgical management of diabetic retinopathy.

Authors:  Vishali Gupta; J Fernando Arevalo
Journal:  Middle East Afr J Ophthalmol       Date:  2013 Oct-Dec

5.  Segmentation and removal of fibrovascular membranes with high-speed 23 G transconjunctival sutureless vitrectomy, in severe proliferative diabetic retinopathy.

Authors:  Erkan Celik; Ozkan Sever; Fatih Horozoglu; Ates Yanyalı
Journal:  Clin Ophthalmol       Date:  2016-05-17

6.  Key Factors to Improve the Outcome of Retinal Reattachment Surgery in Proliferative Vitreoretinopathy and Proliferative Diabetic Retinopathy.

Authors:  Svenja Deuchler; Hanns Ackermann; Pankaj Singh; Thomas Kohnen; Clemens Wagner; Frank Koch
Journal:  J Ophthalmol       Date:  2017-07-09       Impact factor: 1.909

7.  Characteristics and Outcomes of Pars Plana Vitrectomy for Proliferative Diabetic Retinopathy Patients in a Limited Resource Tertiary Center over an Eight-Year Period.

Authors:  Janejit Choovuthayakorn; Preeyanuch Khunsongkiet; Direk Patikulsila; Nawat Watanachai; Paradee Kunavisarut; Voraporn Chaikitmongkol; Nimitr Ittipunkul
Journal:  J Ophthalmol       Date:  2019-03-17       Impact factor: 1.909

8.  Outcomes of vitrectomy for diabetic tractional retinal detachment in Chicago's county health system.

Authors:  Jared T Sokol; Sidney A Schechet; Darin T Rosen; Kevin Ferenchak; Sherif Dawood; Dimitra Skondra
Journal:  PLoS One       Date:  2019-08-20       Impact factor: 3.240

Review 9.  Surgery for Proliferative Diabetic Retinopathy: New Tips and Tricks.

Authors:  Patrick Oellers; Tamer H Mahmoud
Journal:  J Ophthalmic Vis Res       Date:  2016 Jan-Mar

10.  Survival Time of Visual Gains after Diabetic Vitrectomy and Its Relationship with Ischemic Heart Disease.

Authors:  Abdah Khairiah Che Md Noor; Evelyn Li Min Tai; Yee Cheng Kueh; Ab Hamid Siti-Azrin; Zamri Noordin; Ismail Shatriah
Journal:  Int J Environ Res Public Health       Date:  2020-01-02       Impact factor: 3.390

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