Outcomes of Pars Plana Vitrectomy with Panretinal Photocoagulation for Treatment of Proliferative Diabetic Retinopathy Without Retinal Detachment: A Seven-Year Retrospective Study

Background Cystoid macular edema (CME) can develop following silicone oil placement in complex vitreoretinal surgeries, contributing to poor visual outcomes. In this study, we investigated the clinical and surgical characteristics associated with the development of CME following the use of silicone oil (SO) in pars plana vitrectomy (PPV) surgeries. Methods We conducted a retrospective chart review of patients who underwent implantation of SO during PPV from 2010 to 2020 by a single surgeon. Patient demographics, type of oil, duration of oil tamponade, retinectomy size, diabetic status, lens status, prior panretinal photocoagulation, visual acuity, and incidence of CME were reviewed. Results This study included 43 eyes from 40 patients who underwent SO tamponade for retinal detachment (RD) surgery. The mean duration of SO tamponade was 15.7 ± 12.7 months (range: 1–58 months). The most common indication for surgery was diabetic tractional RD (32.7%), followed by traumatic RD (16.3%) and rhegmatogenous RD with proliferative vitreoretinopathy (11.6%). Of the 43 eyes, 18 (41.9%) developed CME for the first time after PPV with SO placement, with 8 (44%) resolving within a year of oil removal. The mean duration for the development of CME was 9 months. A logistic regression model showed that a scleral buckle procedure and poor initial vision were statistically significant factors for predicting the development of CME (ORs: 11.65 and 16.06, respectively). Overall, 91% of the patients had stable or improved vision after surgery. Conclusions The use of a scleral buckle procedure and poor initial vision are significant factors for predicting CME following silicone oil tamponade in PPV surgeries, with 41.9% of patients developing CME with an average duration of 9 months. Recognizing such factors can lead to early monitoring and prompt management of CME. Meeting presentation Partial analyses were presented at the ASRS 2020 conference. Clinical trial number Not applicable.

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Visual Prognosis and Surgical Strategy of Bilateral Pars Plana Vitrectomy for Proliferative Diabetic Retinopathy

Wang,

Li,

Yang

et al. 2024

Preprint

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Purpose This study aimed to analyze the visual outcome in patients with proliferative diabetic retinopathy (PDR) undergoing bilateral pars plana vitrectomy (PPV) to propose an effective surgical strategy. Methods This was a retrospective design of 27 patients (54 eyes) with PDR who underwent bilateral PPV. Univariate and multivariate linear regression analyzed factors affect best-corrected visual acuity (BCVA). Differences between the superior and inferior final BCVA groups were compared using t-tests and chi-squared tests. Results The mean BCVA from 1.85 ± 0.94 Log MAR preoperatively improved to 0.76 ± 0.95 Log MAR at the final follow-up (P < 0.001). The final BCVA was significantly better in male patients than female patients (coefficient = -0.546, 95% CI: -1.048 to -0.044, P = .033), better in the first surgery eye than in the second (coefficient = 0.530, 95% CI: 0.030 to 1.030, P = .038), worse with postoperative neovascular glaucoma (NVG) (coefficient = 0.614, 95% CI: 0.045 to 1.184, P = .035). Fibrinogen (FIB) levels were negatively correlated with the final BCVA (coefficient = 0.723, 95% CI: 0.295 to 1.152, P = .001). Shorter surgical time was positively associated with the final BCVA (P = .040). Conclusion This study suggests that a formulated surgical strategy, including rational selection of the first surgery eye, shorter surgery time, prevention of NVG, and reduction of FIB levels, can significantly improve visual prognosis for patients with PDR undergoing PPV.

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Outcomes of Pars Plana Vitrectomy with Panretinal Photocoagulation for Treatment of Proliferative Diabetic Retinopathy Without Retinal Detachment: A Seven-Year Retrospective Study

Cited by 5 publications

References 29 publications

Clinical Characteristics and Surgical Outcomes of Patients Undergoing Pars Plana Vitrectomy for Proliferative Diabetic Retinopathy

Clinical Characteristics and Surgical Outcomes of Patients Undergoing Pars Plana Vitrectomy for Proliferative Diabetic Retinopathy

Factors affecting the development of cystoid macular edema following pars plana vitrectomy with silicone oil placement: a retrospective cohort study

Visual Prognosis and Surgical Strategy of Bilateral Pars Plana Vitrectomy for Proliferative Diabetic Retinopathy

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