Outcomes of vitrectomy for diabetic tractional retinal detachment in Chicago’s county health system

Sokol, Jared T.; Schechet, Sidney A.; Rosen, Darin T; Ferenchak, Kevin; Dawood, Sherif; Skondra, Dimitra

doi:10.1371/journal.pone.0220726

Cited by 26 publications

(41 citation statements)

References 54 publications

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“…[ 10 12 ] In the era of microincision vitrectomy surgery, overall, the rates of final retinal reattachment have ranged from 67 to 100% with the rate of resurgery having fallen to 6–31%. [ 9 14 ] The rate of the final reattachment was 88.1% and 96.6% in our two groups, respectively. This could partly be explained by the higher proportion of complex detachments with macular involvement in the T1DM group.…”

Section: Discussionmentioning

confidence: 60%

“…[ 10 11 12 ] The outcomes of diabetic vitrectomy in older patients have been widely analyzed. [ 13 14 15 ] Only a few studies have analyzed the outcomes of surgery in young diabetic patients with PDR. [ 10 11 12 ] The previous studies have investigated possible predictors for DR in people with T1DM, however, there is an unmet need to evaluate the surgical outcomes following vitrectomy in T1DM patients.…”

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confidence: 99%

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Clinical features and surgical outcomes of complications of proliferative diabetic retinopathy in young adults with type 1 diabetes mellitus versus type 2 diabetes mellitus - A comparative observational study

Baliga

Kumar

Babu

et al. 2021

Indian Journal of Ophthalmology

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Purpose: To evaluate the clinical profile, visual outcomes, and complications among young adult patients with type 1 diabetes mellitus (insulin-dependent DM-T1DM) in comparison with patients with type 2 diabetes mellitus (T2DM) undergoing vitrectomy for complications of proliferative diabetic retinopathy (PDR). Methods: A retrospective review of patients between 18 and 45 years with T1DM undergoing vitrectomy for complications of PDR between June 2017 and June 2019, with a minimum follow-up of 12 months. Consecutive patients between 30 and 45 years with type 2 diabetes (non-insulin-dependent DM-T2DM) who underwent vitrectomy for the same indications were retrospectively enrolled as the control group. Results: There were 42 eyes (28 patients) in the T1DM group and 58 eyes (47 patients) in the T2DM group. The average age at operation was 35.9 ± 6.88 years and 39.8 ± 3.03 years, respectively ( P < 0.001). At the end of follow-up, the mean logarithm of the minimum angle of resolution (logMAR) best-corrected visual acuity (BCVA) improved from 1.53 ± 0.55 to 1.30 ± 0.93 ( P value 0.07) in the T1DM group and from 1.59 ± 0.46 to 1.00 ± 0.78 in the T2DM group ( P = 0.0001). The rate of the primary and final reattachment was 76.2% and 88.1% in the T1DM group and 84.5% and 96.6% in the T2DM group. Preoperative macular tractional retinal detachment (MTRD) and neovascular glaucoma (NVG) in both the groups, chronic kidney disease (CKD) and lack of preoperative Pan retinal photocoagulation (PRP) in the T1DM group, hypertension (HTN) and, resurgery in the T2DM group, were risk factors for poor vision at the final follow-up. Conclusion: The visual and anatomic outcomes were poorer in the T1DM patients which could be due to the longer duration of diabetes with worse glycemic control, associated comorbidities like CKD, and a higher incidence of MTRD.

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Section: Discussionmentioning

confidence: 60%

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confidence: 99%

Clinical features and surgical outcomes of complications of proliferative diabetic retinopathy in young adults with type 1 diabetes mellitus versus type 2 diabetes mellitus - A comparative observational study

Baliga

Kumar

Babu

et al. 2021

Indian Journal of Ophthalmology

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“…We found that 50% of our cohort experienced visual loss during the study period. This may seem to compare unfavorably with other published results of vitrectomy [11,19], but differences in study objective may serve to explain the discrepancy. Most studies evaluating the outcome of vitrectomy measure success based on visual acuity at a single point in time, and compare their results of patients with improved vision to those who experienced no improvement with surgery.…”

Section: Discussionmentioning

confidence: 54%

Survival Time of Visual Gains after Diabetic Vitrectomy and Its Relationship with Ischemic Heart Disease

Noor

Tai

Kueh

et al. 2020

IJERPH

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Vitrectomy surgery in proliferative diabetic retinopathy improves the vision-related quality of life. However, there is lack of data on the duration of maintenance of visual gains post vitrectomy. This study thus aimed to determine the survival time of visual gains and the prognostic factors of vision loss after vitrectomy surgery for complications of proliferative diabetic retinopathy. A retrospective cohort study was conducted in an ophthalmology clinic in Malaysia. We included 134 patients with type 2 diabetes mellitus on follow-up after vitrectomy for proliferative diabetic retinopathy. Visual acuity was measured using the log of minimum angle of resolution (LogMar). A gain of ≥0.3 LogMar sustained on two subsequent visits was considered evidence of visual improvement post vitrectomy. Subjects were considered to have vision loss when their post-operative visual acuity subsequently dropped by ≥0.3 LogMar. Kaplan–Meier analysis was used to determine the survival time of visual gains. Cox Proportional Hazard regression was used to determine the prognostic factors of vision loss. The median age of patients was 56.00 years (IQR ± 10.00). The median duration of diabetes mellitus was 14.00 years (IQR ± 10.00). Approximately 50% of patients with initial improvement post vitrectomy subsequently experienced vision loss. The survival time, i.e., the median time from surgery until the number of patients with vision loss formed half of the original cohort, was 14.63 months (95% CI: 9.95, 19.32). Ischemic heart disease was a significant prognostic factor of vision loss. Patients with underlying ischemic heart disease (adjusted HR: 1.97, 95% CI: 1.18, 3.33) had a higher risk of vision loss post vitrectomy, after adjusting for other factors. Approximately half the patients with initial visual gains post vitrectomy maintained their vision for at least one year. Ischemic heart disease was a poor prognostic factor for preservation of visual gains post vitrectomy.

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“…With recent advances in techniques of PPV, it is doing a great job in retaining, restoring of sight and prevention of blindness for patients of posterior segment diseases. Increasing number of posterior segment surgeries are being performed worldwide 6,7 . There were more male patients than females.…”

Section: Discussionmentioning

confidence: 99%

The Common Indications of Pars plana vitrectomy (PPV) for posterior Segment Ocular diseases in patients from a Private Retina Clinic

Riaz¹,

Mirza²,

Iqbal³

et al. 2021

PJMHS

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Purpose: To evaluate common indications and anatomical outcomes of PPV for posterior segment ocular diseases in patients presenting at private retina clinic in Lahore Study design: Cross sectional survey Methods and materials: Over the period of three years, from 1st April 2017 to 3oth April 2020, all patients fulfilling inclusion criterion, were included in study after approval from hospital ethical committee. After taking history and detailed ocular examination, diagnosis was confirmed by B scan or OCT, Hepatitis B & C screening done. The patient age, gender, laterality of eye, lens status, macular status, type of retinal pathology, type of anesthesia, procedure done and type of vitreous tamponade if used were noted. All procedures were performed by a single surgical team and patients were followed for six months for anatomical success or any complication. Data was analyzed by SPSS 25. Results: Out of 266 total patients, 168 (63.2%) were males and 98 (36.8%) were females. Right eye was involved in 125 (47%) and left in 141 (53%). Age range was from 2 years to 83years, mean age for males was 47.30, for females 48.07 years, median age was 50 years, mean age for GA was 30.62 years and 51.71 for LA patients. The highest incidences of posterior segment ocular problems were observed in patients with age range 51 to 60 years. The commonest indication for posterior segment surgery were RRD seen in 107 (40.23%), ROSO in 51 (19.17%) and vitreous hemorrhage 33 (12.41%). Endophthalmitis was indication in 20 (7.52%), dropped nucleus in 11 (4.13%), Macular hole in 7 (2.63%) and ERM in 3 (1.13%). Asteroid hyalosis, intraocular IOFB and diagnostic vitrectomy were least common indication, each seen in 1 (0.5%) patient. Silicon oil was most commonly used Endo tamponade used in 138 (51.88%) patients. All patients were followed for 6 months with vision and retinal status. All patients who underwent pars plana vitrectomy surgery were stable with anatomical success rate till 6 months postoperatively except 10 (3.76%) who required re do operation for retinal detachment or some other complications. Conclusion: Current practice in ophthalmology shows increased frequencies of internal approach (PPV) for vitreoretinal diseases rather external approach (SB). Silicon oil was most common internal tamponade used. Diabetic retinopathy was important cause of vitreous hemorrhage and TRD. Patients should be educated regarding regular fundoscopy and good systemic control of diabetes. Higher incidence of retinal detachment among all age groups needs awareness and education about its warning ocular symptoms. Key words: PPV (Pars plana vitrectomy), RRD (Rhegmatogenous retinal detachment), SB (Scleral buckling), TRD (Tractional retinal detachment), ROSO (removal of silicon oil), GA (general anesthesia), LA (local anesthesia)

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Outcomes of vitrectomy for diabetic tractional retinal detachment in Chicago’s county health system

Cited by 26 publications

References 54 publications

Clinical features and surgical outcomes of complications of proliferative diabetic retinopathy in young adults with type 1 diabetes mellitus versus type 2 diabetes mellitus - A comparative observational study

Clinical features and surgical outcomes of complications of proliferative diabetic retinopathy in young adults with type 1 diabetes mellitus versus type 2 diabetes mellitus - A comparative observational study

Survival Time of Visual Gains after Diabetic Vitrectomy and Its Relationship with Ischemic Heart Disease

The Common Indications of Pars plana vitrectomy (PPV) for posterior Segment Ocular diseases in patients from a Private Retina Clinic

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