PURPOSE: To analyze the prevalence of residual subfoveal fluid (RSF) after pars plana vitrectomy in patients with proliferative diabetic retinopathy complicated by tractional detachment of the macula and the effect of RSF on the postoperative visual outcome. METHODS: This study was a prospective observational case study of the optical coherence tomography (OCT) records of 23 patients (24 eyes) with macula-off diabetic tractional retinal detachment (TRD) who underwent successful 23-gauge pars plana vitrectomy between July 2012 and December 2015. RESULTS: The prevalence of RSF on OCT examination was 100% at 1 and 2 months, 91.7% at 3 months, 70.8% at 6 months, 25.0% at 9 months and 4.2% at 12 months after surgery (p < 0.001). Internal drainage of subretinal fluid (SRF) during primary surgery was performed in 13 (54.2%) eyes. The significant risk factor that was predictive of long-standing RSF was non-drainage of SRF (p = 0.04). CONCLUSION: Persistent RSF is a common OCT finding after clinically successful vitrectomy surgery for the treatment of macula-off diabetic tractional retinal detachment. Internal drainage of SRF with active aspiration can be attempted if intraoperative breaks are found or if faster recovery is required. To date, observation seems to be the best option.
PURPOSE: To analyze the prevalence of residual subfoveal fluid (RSF) after pars plana vitrectomy in patients with proliferative diabetic retinopathy complicated by tractional detachment of the macula and the effect of RSF on the postoperative visual outcome. METHODS: This study was a prospective observational case study of the optical coherence tomography (OCT) records of 23 patients (24 eyes) with macula-off diabetic tractional retinal detachment (TRD) who underwent successful 23-gauge pars plana vitrectomy between July 2012 and December 2015. RESULTS: The prevalence of RSF on OCT examination was 100% at 1 and 2 months, 91.7% at 3 months, 70.8% at 6 months, 25.0% at 9 months and 4.2% at 12 months after surgery (p < 0.001). Internal drainage of subretinal fluid (SRF) during primary surgery was performed in 13 (54.2%) eyes. The significant risk factor that was predictive of long-standing RSF was non-drainage of SRF (p = 0.04). CONCLUSION: Persistent RSF is a common OCT finding after clinically successful vitrectomy surgery for the treatment of macula-off diabetic tractional retinal detachment. Internal drainage of SRF with active aspiration can be attempted if intraoperative breaks are found or if faster recovery is required. To date, observation seems to be the best option.
Authors: Lisa S Schocket; Andre J Witkin; James G Fujimoto; Tony H Ko; Joel S Schuman; Adam H Rogers; Caroline Baumal; Elias Reichel; Jay S Duker Journal: Ophthalmology Date: 2006-04 Impact factor: 12.079