Refining Vitrectomy for Proliferative Diabetic Retinopathy

Overview

Journal Graefes Arch Clin Exp Ophthalmol

Specialty Ophthalmology

Date 2023 Jun 14

PMID 37314522

Authors

San-Ni Chen

Shih-Jen Chen

Tsung-Tien Wu

Wei-Chi Wu

Chang-Hao Yang

Chung-May Yang

Affiliations

Soon will be listed here.

Abstract

Pars plana vitrectomy (PPV) is the main treatment modality for patients with severe diabetic retinopathy. With the development of systems for microincision, wide-angle viewing, digitally assisted visualization, and intraoperative optical coherence tomography, contemporary PPV for diabetic retinopathy has been performed on a wider range of indications than previously considered. In this article, we reviewed, in conjunction with our collective experiences with Asian patients, the applications of new technologies for PPV in eyes with diabetic retinopathy and highlighted several important procedures and entities not generally reiterated in the literature, in order for vitreoretinal surgeons to optimize their approaches when facing the challenges imposed by the complications in diabetic eyes.

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References

Helbig H, Sutter F . Surgical treatment of diabetic retinopathy. Graefes Arch Clin Exp Ophthalmol. 2004; 242(8):704-9. DOI: 10.1007/s00417-004-0977-9. View

El Annan J, Carvounis P . Current management of vitreous hemorrhage due to proliferative diabetic retinopathy. Int Ophthalmol Clin. 2014; 54(2):141-53. PMC: 3980167. DOI: 10.1097/IIO.0000000000000027. View

Oellers P, Mahmoud T . Surgery for Proliferative Diabetic Retinopathy: New Tips and Tricks. J Ophthalmic Vis Res. 2016; 11(1):93-9. PMC: 4860995. DOI: 10.4103/2008-322X.180697. View

Cruz-Inigo Y, Acaba L, Berrocal M . Surgical management of retinal diseases: proliferative diabetic retinopathy and traction retinal detachment. Dev Ophthalmol. 2014; 54:196-203. DOI: 10.1159/000360467. View

Chen P, Chen Y, Chen S . Comparison of 27-gauge and 25-gauge vitrectomy in the management of tractional retinal detachment secondary to proliferative diabetic retinopathy. PLoS One. 2021; 16(3):e0249139. PMC: 7993849. DOI: 10.1371/journal.pone.0249139. View

Khan M, Kuley A, Riemann C, Berrocal M, Lakhanpal R, Hsu J . Long-Term Visual Outcomes and Safety Profile of 27-Gauge Pars Plana Vitrectomy for Posterior Segment Disease. Ophthalmology. 2017; 125(3):423-431. DOI: 10.1016/j.ophtha.2017.09.013. View

Berrocal M . ALL-PROBE VITRECTOMY DISSECTION TECHNIQUES FOR DIABETIC TRACTIONAL RETINAL DETACHMENTS: Lift and Shave. Retina. 2017; 38 Suppl 1:S2-S4. DOI: 10.1097/IAE.0000000000001884. View

Tieger M, Rodriguez M, Wang J, Obeid A, Ryan C, Gao X . Impact of contact versus non-contact wide-angle viewing systems on outcomes of primary retinal detachment repair (PRO study report number 5). Br J Ophthalmol. 2020; 105(3):410-413. DOI: 10.1136/bjophthalmol-2020-315948. View

Palacios R, de Carvalho A, Maia M, Caiado R, Camilo D, Farah M . An experimental and clinical study on the initial experiences of Brazilian vitreoretinal surgeons with heads-up surgery. Graefes Arch Clin Exp Ophthalmol. 2019; 257(3):473-483. DOI: 10.1007/s00417-019-04246-w. View

10.

Kantor P, Matonti F, Varenne F, Sentis V, Pagot-Mathis V, Fournie P . Use of the heads-up NGENUITY 3D Visualization System for vitreoretinal surgery: a retrospective evaluation of outcomes in a French tertiary center. Sci Rep. 2021; 11(1):10031. PMC: 8113355. DOI: 10.1038/s41598-021-88993-z. View

11.

Gabr H, Chen X, Zevallos-Carrasco O, Viehland C, Dandrige A, Sarin N . VISUALIZATION FROM INTRAOPERATIVE SWEPT-SOURCE MICROSCOPE-INTEGRATED OPTICAL COHERENCE TOMOGRAPHY IN VITRECTOMY FOR COMPLICATIONS OF PROLIFERATIVE DIABETIC RETINOPATHY. Retina. 2018; 38 Suppl 1:S110-S120. PMC: 6039290. DOI: 10.1097/IAE.0000000000002021. View

12.

Nishitsuka K, Nishi K, Yamashita H . Effectiveness of intraoperative optical coherence tomography on vitrectomy for proliferative diabetic retinopathy. Jpn J Ophthalmol. 2022; 66(6):527-533. DOI: 10.1007/s10384-022-00944-x. View

13.

Sharma T, Fong A, Lai T, Lee V, Das S, Lam D . Surgical treatment for diabetic vitreoretinal diseases: a review. Clin Exp Ophthalmol. 2016; 44(4):340-54. DOI: 10.1111/ceo.12752. View

14.

Stewart M, Browning D, Landers M . Current management of diabetic tractional retinal detachments. Indian J Ophthalmol. 2018; 66(12):1751-1762. PMC: 6256889. DOI: 10.4103/ijo.IJO_1217_18. View

15.

Huang C, Hsieh Y, Yang C . Vitrectomy for complications of proliferative diabetic retinopathy in young adults: clinical features and surgical outcomes. Graefes Arch Clin Exp Ophthalmol. 2017; 255(5):863-871. DOI: 10.1007/s00417-016-3579-4. View

16.

Yeh P, Yang C, Yang C . Intravitreal bevacizumab injection for recurrent vitreous haemorrhage after diabetic vitrectomy. Acta Ophthalmol. 2010; 89(7):634-40. DOI: 10.1111/j.1755-3768.2009.01821.x. View

17.

Chen J, Chen L, Chen S, Chen W, Cheng C, Hsu S . Management of diabetic macular edema: experts' consensus in Taiwan. Jpn J Ophthalmol. 2020; 64(3):235-242. DOI: 10.1007/s10384-020-00741-4. View

18.

Jackson T, Nicod E, Angelis A, Grimaccia F, Pringle E, Kanavos P . PARS PLANA VITRECTOMY FOR DIABETIC MACULAR EDEMA: A Systematic Review, Meta-Analysis, and Synthesis of Safety Literature. Retina. 2016; 37(5):886-895. DOI: 10.1097/IAE.0000000000001280. View

19.

Nawrocka Z, Nawrocka Z, Nawrocki J . Vitrectomy with ILM peeling in diabetic macular edema in one eye vs. intravitreal anti-VEGF injections in the second eye: a comparative study. Graefes Arch Clin Exp Ophthalmol. 2022; 261(1):67-76. DOI: 10.1007/s00417-022-05774-8. View

20.

Su C, Yang C, Yeh P, Yang C . Macular tractional retinoschisis in proliferative diabetic retinopathy: clinical characteristics and surgical outcome. Ophthalmologica. 2013; 231(1):23-30. DOI: 10.1159/000355078. View