Evaluation of Retinal Detachment After Diabetic Vitrectomy: Causes and Ways of Management
Received 23 October 2019
Accepted for publication 9 December 2019
Published 9 January 2020 Volume 2020:14 Pages 53—60
Checked for plagiarism Yes
Review by Single-blind
Peer reviewer comments 3
Editor who approved publication: Dr Scott Fraser
Ahmed M Abdelhadi, Hany Ahmed Helaly, Amr Abuelkeir
Ophthalmology Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
Correspondence: Hany Ahmed Helaly
Ophthalmology Department, Faculty of Medicine, Alexandria University, 30 Roshdy Street, Roshdy, Alexandria, Egypt
Tel +20 1225466733
Purpose: To assess the causes and the ways of management of rhegmatogenous retinal detachment (RRD) after pars plana vitrectomy (PPV) performed in diabetic patients with advanced diabetic eye disease.
Methods: Retrospective review of the records of the patients who had undergone PPV for complicated proliferative diabetic retinopathy (PDR) was done. Cases with RRD after the PPV were analyzed in the study (n = 32). Preoperative, operative, and postoperative data of the patients were recorded. All patients were recruited for a final follow-up visit.
Results: This retrospective case-control study included 400 eyes of 345 patients. Prolonged surgical duration increased the risk of developing RRD (odds ratio = 1.6342, p = 0.0321). The presence of intraoperative retinal breaks increased the risk of developing postoperative RRD (odds ratio = 2.2308, p = 0.0380). Also, complex diabetic detachment that needed for bimanual dissection of the membranes during surgery were associated with a higher risk of developing postoperative RRD (odds ratio = 2.7311, p = 0.0401).
Conclusion: Rhegmatogenous retinal detachment following diabetic vitrectomy needs a further vitrectomy for the management and usually has poor visual outcome. Prolonged surgical duration, the presence of intraoperative retinal breaks, and the need for bimanual dissection of the membranes (major complex cases) during surgery were associated with higher risk of developing RRD postoperatively.
Keywords: vitrectomy, proliferative diabetic retinopathy, recurrent retinal detachment, complications, proliferative vitreoretinopathy, retinal break
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