Vitrectomy for diabetic retinopathy: A review of indications, techniques, outcomes, and complications

Abstract

Diabetic retinopathy is one of the most severe forms of retinopathy and a leading cause of blindness all over the world. Of a greater concern is proliferative diabetic retinopathy which leads to vitreous haemorrhage and tractional retinal detachment in such cases. A majority of these cases require a surgical intervention to improve vision and prevent further vision loss. Surgical manouevers in these cases require a complex combination of vitrectomy, membrane dissection, judious usage of endodiathermy, endolaser, vital dyes, bimanual dissection and usage of intraoperative and post-operative tamponades. Each case presents a unique challenge and necessitates an appropriate combination of the steps mentioned above. In the current review we present the current understanding of the need for surgery in diabetic retinopathy, various surgical approaches and a summary of current literature on the same. Multiple surgical video clips demonstrating these steps are also included in this review.

Keywords: Diabetic vitrectomy; posterior hyaloid; proliferative diabetic retinopathy; subhyaloid hemorrhage; vitreous hemorrhage.

Figure 1

Pre and post fundus photograph of subhyaloid hemorrhage

Figure 2

Pre and post photograph of vitreomacular traction and adhesion

Figure 3

Pre and post fundus photo of progressive fibrovascular proliferation