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J. A. Fortun, G. B. Hubbard, III; Viscodissection Assisted 25 Gauge Vitrectomy for the Surgical Management of Tractional Retinal Detachments in Proliferative Diabetic Retinopathy. Invest. Ophthalmol. Vis. Sci. 2009;50(13):4195.
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© ARVO (1962-2015); The Authors (2016-present)
To report on the initial results of the surgical managment of diabetic tractional retinal detachments using 25-gauge vitrectomy and a newly developed 25-gauge viscodissection instrument.
Single surgeon (GBH), consecutive case series of 20 eyes with severe proliferative diabetic retinoapthy and broad, diffusely adherent fibrovascular membranes with tractional retinal detachments who underwent viscodissection assisted 25 gauge vitrectomy. The newly developed viscodissection instrument was used in all cases.
The median pre-op visual acuity was 20/400 (range 20/40-5/200). Pre-operative intravitreal bevacizumab was administerd in 12 of 20 eyes. Only 1 of 20 cases required additional dissection with intraocular scissors. All retinas were attached at last follow-up (mean follow-up of 6 months;range 1-21 months). 6 month visual acuity was available for 14 out of 20 eyes, with a median visual acuity of 20/50 (range 20/30 to 5/200). 10 out of 14 eyes showed improvement in visual acuity. 4 out of 14 eyes maintained the same level of vision. No eyes had worsening in visual acuity. Only 1 out of 14 eyes required re-operation (for persistent vitreous hemorrhage).
By providing controlled and directional injection of viscoelastic, this newly developed viscodissection instrument allows for the successful surgical management of complex diabetic tractional retinal detachments with small gauge vitrectomy instrumentation.
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