Aim: To determine preoperative demographic, clinical, and optical coherence tomography (OCT) factors which might predict the visual and anatomical outcome at 1 year in patients undergoing vitrectomy and inner limiting membrane peel for diabetic macular oedema (DMO). Methods: A prospective, interventional case series of 33 patients who completed 1 year follow up. Measurements were taken preoperatively and at 1 year. Outcome measures were logMAR visual acuity (VA) and OCT macular thickness. A priori explanatory variables included baseline presence of clinical and/or OCT signs suggesting macular traction, grade of diabetic maculopathy, posterior vitreous detachment, fluorescein leakage and ischaemia on angiography, presence of subretinal fluid, and peroperative indocyanine green (ICG) use. T he majority of published reports 1-35 regarding vitrectomy for diabetic macular oedema (DMO) are retrospective with varying inclusion criteria, methodology, and follow up. Most studies have suggested that the procedure is effective, particularly in those with clinically evident signs of a taut thickened posterior hyaloid (TTPH 1 ). In the first published randomised controlled trial (RCT) on this subject we found that vitrectomy with internal limiting membrane (ILM) peeling did not improve the visual acuity (VA) of patients with a clinically attached but otherwise normal posterior hyaloid. 24 To investigate whether there are subgroups within which vitrectomy is an effective intervention we have prospectively studied a cohort of patients, all with 1 year follow up, who underwent vitrectomy for chronic DMO. PATIENTS AND METHODSEthics approval was obtained (EC 00/004). Patients included were over 21 years of age with diffuse or diffuse and focal DMO in an eye that had already received one or more grid laser treatments no less than 3 months previously. VA of Snellen 6/12 or worse and the ability to give informed consent was required. Exclusion criteria were acuity impairing ocular co-morbidity, active proliferative retinopathy, uncontrolled hypertension (blood pressure .140/95) or severe renal impairment. VA was measured in logMAR using a standardised methodology. 24The vitreous, macula, and vitreomacular interface were examined clinically (DAHL) for the features of a PVD, TTPH, and epiretinal membrane (ERM). PVD was defined as a Weiss ring or continuous folded layer of optically dense vitreous behind which no normal vitreous structure could be clinically defined. Preoperative colour imaging and fluorescein angiography (FFA) was performed using the standard 30 degree seven field Diabetic Retinopathy Study protocol. Images were graded by the Retinopathy Grading Centre, London. The presence of haemorrhages, microaneurysms, and exudates in field 2 photographs (macula) were each graded 0-5 against standardised photographs, 37 with the results averaged to produce a maculopathy score (0-5). FFAs were graded for ischaemia and leakage. Ischaemia was graded from 0-4: four quadrants were marked out within a 0.5 disc diameter (DD) marker centr...

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Sympathetic Ophthalmia (SO) is a rare disease that presents as a bilateral, diffuse, granulomatous panuveitis. Sympathetic Ophthalmia is a clinical diagnosis with history of penetrating ocular injury in the inciting eye and presence of panuveitis in the sympathizing eye. Though early enucleation is believed to minimize the risk, there have been reports of SO even after enucleation of inciting eyes. The possible association between vitrectomy and SO has been initially proposed by Gass [9] and later studied extensively in a large cohort in the UK with an estimated SO risk of 1 in 799 vitrectomies [11]. There have been several case series and reports of SO following vitrectomy, however only three documented cases of SO following vitrectomy without use of silicone oil. These cases demonstrated an onset of SO ranging between 4 weeks to 2 months. We present a patient with SO in the sympathizing eye presenting 16 days after an uncomplicated 23-gauge (23G) sutureless pars plana vitrectomy (PPV) without the use of silicone oil.

Sympathetic Ophthalmia (SO) is a rare disease that presents as a bilateral, diffuse, granulomatous panuveitis. Sympathetic Ophthalmia is a clinical diagnosis with history of penetrating ocular injury in the inciting eye and presence of panuveitis in the sympathizing eye. Though early enucleation is believed to minimize the risk, there have been reports of SO even after enucleation of inciting eyes. The possible association between vitrectomy and SO has been initially proposed by Gass [9] and later studied extensively in a large cohort in the UK with an estimated SO risk of 1 in 799 vitrectomies [11]. There have been several case series and reports of SO following vitrectomy, however only three documented cases of SO following vitrectomy without use of silicone oil. These cases demonstrated an onset of SO ranging between 4 weeks to 2 months. We present a patient with SO in the sympathizing eye presenting 16 days after an uncomplicated 23-gauge (23G) sutureless pars plana vitrectomy (PPV) without the use of silicone oil.