May 2004
Volume 45, Issue 13
Free
ARVO Annual Meeting Abstract  |   May 2004
Influence of Lens Status Upon Anatomic Results for Diabetic Vitrectomy
Author Affiliations & Notes
  • Y. Akar
    Ophthalmology, Columbia University, New York, NY
  • J.J. Tseng
    Ophthalmology, Columbia University, New York, NY
  • W.M. Schiff
    Ophthalmology, Columbia University, New York, NY
  • G.R. Barile
    Ophthalmology, Columbia University, New York, NY
  • O. Cekic
    Ophthalmology, Columbia University, New York, NY
  • O. Vidne–Hay
    Ophthalmology, Columbia University, New York, NY
  • S. Chang
    Ophthalmology, Columbia University, New York, NY
  • Footnotes
    Commercial Relationships  Y. Akar, None; J.J. Tseng, None; W.M. Schiff, None; G.R. Barile, None; O. Cekic, None; O. Vidne–Hay, None; S. Chang, None.
  • Footnotes
    Support  none
Investigative Ophthalmology & Visual Science May 2004, Vol.45, 4167. doi:
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      Y. Akar, J.J. Tseng, W.M. Schiff, G.R. Barile, O. Cekic, O. Vidne–Hay, S. Chang; Influence of Lens Status Upon Anatomic Results for Diabetic Vitrectomy . Invest. Ophthalmol. Vis. Sci. 2004;45(13):4167.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Abstract: : Purpose: Historical studies have suggested that the lens may provide a barrier to the angiogenic stimulus in proliferative diabetic retinopathy (PDR), reducing the risk of rubeosis iridis (RI). With the use of modern vitreoretinal techniques including endophotocoagulation, the rationale for preserving the lens during diabetic vitrectomy may be less compelling. The lens may also serve as an impediment during intraoperative surgical maneuvers and, due to postoperative cataract progression, subsequent visual recovery. This study sought to determine the effect of lens status upon anatomic results in primary diabetic vitrectomy. Methods: A total of 151 eyes of patients with PDR were included in the study. Preoperatively, 93 eyes were phakic and the remaining eyes (n=58) were either aphakic (n=8) or pseudophakic (n=50). At the time of initial vitrectomy, 14 eyes underwent lensectomy and 9 patients underwent lens extraction and IOL implantation. The eyes that remained phakic after surgery (n=70) were compared to the eyes that were either aphakic or pseudophakic (nonphakic, n=81) with respect to intraoperative and postoperative complications and ultimate anatomic success. Results: Despite the nonphakic eyes having worse preoperative traction, these eyes had reduced intraoperative complications and higher initial postoperative success rates compared to phakic eyes, as summarized in the table below. Rubeosis iridis developed in 3 eyes (1 phakic and 2 pseudophakic eyes). 

Conclusions: Phakic eyes undergoing diabetic vitrectomy have higher rates of intraoperative complications, postoperative vitreous hemorrhage and recurrent retinal detachment than eyes made nonphakic before or during vitrectomy surgery. Rubeosis iridis does not appear to be a major postoperative risk when removing the lens before or during surgery using current vitreoretinal techniques. This study suggests that diabetic eyes undergoing vitrectomy be rendered pseudophakic before or during surgery to decrease the rates of both intra– and post–operative severe complications.

Keywords: vitreoretinal surgery • diabetes • diabetic retinopathy 
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