Diabetic vitrectomy

Abstract

Diabetic vitrectomy is usually performed to remove vitreous blood or to relieve traction of the macula. In addition to removing vitreous opacities and severing all anteroposterior connections of the posterior hyaloid face with a cutting and sucking probe, tangential traction in and around the macula is eliminated by sectioning preretinal membranes with intraocular scissors. Complications are significant in terms of both their incidence and their consequences. They include choroidal or subretinal infusion, peripheral and posterior retinal breaks, intraoperative bleeding, and neovascular glaucoma. Proper management can minimize the occurrence and adverse effects of these complications. If prognostic factors are favorable, visual improvement occurs in 78 to 59% of eyes postoperatively. Preoperative iris neovascularization, florid proliferative diabetic retinopathy, long-standing detachment of the macula, and iatrogenic retinal breaks are all correlated with significantly lower success rates. Three independent studies have shown that if visual improvement is present 6 months postoperatively, the results are usually long-standing [2, 8, 20].