First Author: J.Gonzalez Cortes MEXICO
Co Author(s): A. Gonzalez Martinez Y. Bages Rousselon J. Davila Villarreal H. Trevino Rodriguez E. Gutierrez Enriquez C. Azuara Azuara
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To establish if 25G pars plana vitrectomy in severe proliferative diabetic retinopathy is a reproducible choice to improve visual acuity.
Departamento de Oftalmología. Hospital Universitario. Facultad de Medicina. UANL. Monterrey Nuevo León México
Descriptive, retrospective, longitudinal study of 68 patients with diagnosis of severe proliferative diabetic retinopathy with or without rubeosis iridis, macular involving retinal detachment, and previous panphotocoagulation of the retina, where 25G pars plana vitrectomy (PPV) was performed by the same retinal surgeon (JHG) with a follow up of at least 6 months. Patients were divided into 5 groups depending on visual acuity: Light perception (LP), hand movement (HM), finger counting (FC), 20/400 to 20/160, and 20/125 or better. Evaluation of best corrected visual acuity (BCVA) was evaluated preoperatively, in the first 24 hours after surgery, and 6 months after surgery. Additionally, they were divided into 3 groups depending on the type of tamponade: silicone oil, perfluorocabonate gas, and balanced saline solution to evaluate best possible outcome.
Preoperative versus postoperative visual acuity PL 5.9% vs 7.4%, HM 35.3% vs 20.6%, FC 36.8% vs 14.7%, 20/400-20/160 10.3% vs 23.5%, and 20/125 or better 11.8% vs 29.4%. The type of tamponade used was gas in 17.6%, balanced saline solution in 26.5%, and silicone oil in 55.9%. 25% of patients required reintervention. 41.18% presented the following complications: neovascular glaucoma 8.8%, retinal redetachment 8.8%, vitreous bleeding 8.8%, intraocular hipertension 7.4%, and other 7.4%. No variable was statistically significant regarding improvement of BCVA.
Most patients under 25 G PPV improve or stabilize visual acuity, and no preoperative or transurgical factors are related to the final visual acuity.