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I. Mitrut, G. Lascaratos, M. Gupta, S. Saidkasimova, H. Bennett; Long Term Follow Up Following Vitrectomy for Proliferative Diabetic Retinopathy. Invest. Ophthalmol. Vis. Sci. 2010;51(13):2961.
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To evaluate the natural course of retinopathy following vitrectomy for proliferative diabetic retinopathy (DR) and the need for further interventions.
Retrospective study of 50 patients who underwent vitrectomy with endolaser for proliferative DR. Patients’ best corrected visual acuity (BCVA) preoperatively and postoperatively as well as complications and surgical interventions at yearly reviews during 5 year follow up were recorded.
Indications for surgery were non-resolving vitreous hemorrhage (VH) in 46 patients and traction retinal detachment (TRD) in 4 patients.47 patients had argon laser pan-retinal photocoagulation (PRP) prior to the original vitrectomy. Three patients had VH with no previous laser treatment.Five patients lost more than 0.2 LogMAR BCVA at the fifth year review compared to the first year. The causes were diabetic maculopathy, corneal ulcer, and retinal detachment within 2 years postoperatively. Epiretinal membrane and macular degeneration occurred during the fourth year of follow up. (See Table for BCVA results).19 patients required further surgical intervention. Within the first 3 years postoperatively 5 patients required phacovitrectomy, 1 vitrectomy, 7 cataract operation alone, 1 amniotic membrane graft and 2 membrane peel. During the fourth year of follow up 3 patients underwent cataract operation. In addition, 3 patients developed VH, 1 TRD, 1 retinal tear and 2 diabetic maculopathy within 2 years after primary vitrectomy. In the same time period 4 patients required further PRP and 5 focal laser. One patient developed rubeosis in the fourth year.
We conclude from this study that follow up within the hospital service may be unnecessary beyond 3 years. This information could aid service planning for diabetic eye care, for example discharge of these patients to the community optometrist with a final fundal photograph. We anticipate further investigation of this hypothesis by prospective study of our surgical diabetic patients.
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