Incidence of Rhegmatogenous Retinal Detachment After Vitrectomy in Eyes of Diabetic Patients

Schrey, S; Krepler, Katharina; Wedrich, Andreas

doi:10.1097/00006982-200602000-00004

Cited by 36 publications

(23 citation statements)

References 11 publications

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“…Anatomical results are often limited by the extent and degree of fibrous tissue, 17 vitreoretinal adhesion, 17 and high rates of iatrogenic tears, which complicate the surgery. 18,19 Some of these eyes require silicone oil as a primary endotamponade to achieve stable retina at the time of primary vitrectomy. Functional visual outcome are also limited due to severe macular dysfunction from a long duration of macular traction and preceding ischemic maculopathy.…”

Section: Discussionmentioning

confidence: 99%

Surgical and visual outcome following 20-gauge vitrectomy in proliferative diabetic retinopathy over a 10-year period, evidence for change in practice

Gupta

Wong

Sivaprasad

et al. 2012

Eye

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Introduction The study reports 10-year anatomical and visual outcome in patients who underwent pars plana vitrectomy (PPV) for complications due to proliferative diabetic retinopathy (PDR). Methods Retrospective analysis of patients undergoing 20G PPV from January 1999 to May 2010 for tractional retinal detachment (TRD) and non-clearing vitreous hemorrhage (NCVH) secondary to PDR recorded prospectively on an electronic patient record. The primary aim was to study anatomical success and eyes with visual acuity (VA) of r0.3 logMAR at last follow-up. Results There were 346 eyes of 249 patients with mean age of 55.63 years and follow-up of 1.44 years. In all, 95.3% of eyes had a flat retina at final follow-up. Overall 136/346 (39.4%) eyes had final VA of logMAR r0.3 (Snellen 6/12) and 129 (37.3%) had logMAR Z1.0 (Snellen 6/60). In all, 50/181 (27.6%) eyes with TRD and 84/165 (50.9%) with NCVH achieved final VA of r0.3 logMAR (Snellen 6/12). A total of 218 (63.1%) showed Z0.3 logMAR improvement from baseline to last follow-up. Both preoperative VA and final postoperative (post-op) VA (Po0.001) improved significantly with each year from 1999 to 2010. The commonest peroperative complication was iatrogenic retinal tear formation (28.4%). This was a risk factor for the development of post-op retinal detachment, odds ratio: 3.90 (95% confidence interval: 1.91-7.97, P ¼ 0.0002). Silicone oil was used in 5.2% of patients at the

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Section: Discussionmentioning

confidence: 99%

Surgical and visual outcome following 20-gauge vitrectomy in proliferative diabetic retinopathy over a 10-year period, evidence for change in practice

Gupta

Wong

Sivaprasad

et al. 2012

Eye

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“…Rhegmatogenous retinal detachment (incidence around 5%) is a serious complication resulting from peripheral or, less commonly, posterior retinal breaks which can rapidly lead to proliferative vitreoretinopathy and/or anterior segment neovascularisation. 26,40 It is important that every diabetic vitrectomy includes a careful peripheral retinal examination in order to identify and treat any peripheral retinal breaks. 20 Rhegmatogenous retinal detachments can usually be treated by further vitrectomy surgery, although the visual outcome is often poor.…”

Section: Complications After Diabetic Vitrectomymentioning

confidence: 99%

“…20 Rhegmatogenous retinal detachments can usually be treated by further vitrectomy surgery, although the visual outcome is often poor. 26,40 Neovascular glaucoma (incidence around 3%) is generally restricted to cases with severe retinal ischaemia and inadequate laser photocoagulation. 26 Treatment comprises urgent panretinal photocoagulation with consideration of adjunctive intravitreal anti-VEGF therapy.…”

Section: Complications After Diabetic Vitrectomymentioning

confidence: 99%

Surgical management of the late complications of proliferative diabetic retinopathy

Newman

2010

Eye

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The late complications of proliferative diabetic retinopathy (PDR) comprise vitreous haemorrhage, tractional retinal detachment, combined tractional-rhegmatogenous retinal detachment, and severe fibrovascular proliferation (including macular distortion or dragging, tractional macular oedema, and media opacity due to fibrovascular tissue). This article will review the indications, techniques, and outcomes of vitrectomy surgery to treat these conditions. A careful assessment of the surgical anatomy, with particular attention to the configuration of vitreoretinal attachments, is important when determining the precise surgical procedure required. The surgical outcome after diabetic vitrectomy has steadily improved with advances in vitreoretinal surgical instrumentation and technique. Significant post-operative complications may, however, occur including cataract formation, recurrent vitreous cavity haemorrhage (early or delayed), rhegmatogenous retinal detachment, and neovascular glaucoma. Most patients will regain or retain useful vision after diabetic vitrectomy, although the visual outcome does remain unpredictable. The development of adjunctive pharmacotherapy should enable further improvements in visual outcome in the future.

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“…Rhegmatogenous retinal detachment (RRD) after vitrectomy is usually due to retinal tears not found intraoperatively and requires urgent treatment to prevent the development of proliferative vitreoretinopathy (PVR) and/or rubeosis iridis (14,42) . In another study, the incidence of DRR was 4.7% (43) . The risk of RRD after vitrectomy in diabetic patients seems to be decreasing, probably due to the use of systems for Surgical management of diabetic retinopathy wide-angle viewing, which provides a more detailed and accurate view of the peripheral retina (43,44) , and new 23-gauge and 25-gauge vitrectomy systems (45,46) .…”

Section: Surgical Complicationsmentioning

confidence: 89%

“…In another study, the incidence of DRR was 4.7% (43) . The risk of RRD after vitrectomy in diabetic patients seems to be decreasing, probably due to the use of systems for Surgical management of diabetic retinopathy wide-angle viewing, which provides a more detailed and accurate view of the peripheral retina (43,44) , and new 23-gauge and 25-gauge vitrectomy systems (45,46) . Retinal detachment is associated with rubeosis iridis in up to 83% of cases (32) .…”

Section: Surgical Complicationsmentioning

confidence: 89%

Tratamento cirúrgico da retinopatia diabética

Sabrosa

Gouvea

et al. 2013

Rev. bras.oftalmol.

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RESUMOA retinopatia diabética é a causa mais frequente de cegueira na população ativa nos países desenvolvidos. A prevalência da retinopatia diabética aumenta com a duração da diabetes, e praticamente 100% dos pacientes com diabetes tipo I (DM I) e mais do que 60% dos pacientes com o tipo II (DM II) apresentarão algum sinal de retinopatia após 20 anos. Além de um controle sistêmico rigoroso dos níveis glicêmicos, lipídicos, colesterol e da pressão arterial, o exame oftalmológico de rotina, com a identificação precoce da retinopatia diabética, podem detectar anormalidades em estágios primários, o que possibilita o tratamento ainda na fase inicial do problema; o uso adequado da fotocoagulação e a utilização da terapia antiangiogênica pode reduzir o número de pacientes com hemorragia vítrea ou descolamento tracional da retina. Infelizmente, em vários pacientes, a retinopatia progride mesmo com as melhores condutas tomadas pelo paciente e pelo oftalmologista, embora vários olhos podem se beneficiar com o tratamento cirúrgi-co, a vitrectomia posterior via pars plana. Esta revisão apresenta as indicações atuais para cirurgia vitreorretiniana em pacientes portadores de retinopatia diabética proliferativa.

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Incidence of Rhegmatogenous Retinal Detachment After Vitrectomy in Eyes of Diabetic Patients

Abstract: RRD occurs in a small percentage of patients after PPV with or without gas tamponade for vitreous hemorrhage or tractional retinal detachment caused by proliferative diabetic retinopathy. Thorough postoperative follow-up is important to make early diagnosis and intervention possible.

Cited by 36 publications

References 11 publications

Surgical and visual outcome following 20-gauge vitrectomy in proliferative diabetic retinopathy over a 10-year period, evidence for change in practice

Surgical and visual outcome following 20-gauge vitrectomy in proliferative diabetic retinopathy over a 10-year period, evidence for change in practice

Surgical management of the late complications of proliferative diabetic retinopathy

Tratamento cirúrgico da retinopatia diabética

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