Abstract
Purpose :
Chicago Cook County Hospital Health System (CCHHS) is one of the oldest and largest public county hospitals in the USA, serving a diabetic patient population unlikely to have benefited from any preventative screening or continuity of care measures which is a unique subset, unrepresentative of the general population with severe diabetic pathology and advanced diabetic tractional detachments. Aim of this study is to investigate anatomical and functional outcomes of repair of diabetic TRD by a single surgeon in the newly established vitrectomy service of CCHHS.
Methods :
Consecutive retrospective review of patients surgically treated by a single surgeon (DS) for diabetic TRD at CCHHS. Fifty-three eyes of 49 patients were treated for diabetic TRD in the first 18 months of the vitreoretinal service starting November 2013 till early May 2015 Average age was 47 years and average HgbA1c was 8.17%. Severe fibrovascular proliferation was present in 40 of 53 eyes (76%). 23G PPV alone was performed in 48 of 53 eyes (90.6%) while in 5 of 53 cases (9.4%) scleral buckle was combined with PPV. Gas tamponade with C3F8 was used in 47 of 53 cases (89%) while silicon oil tamponade was used in 5 of 53 cases (9.4%).
Results :
After a mean follow-up of 8.5 months, successful retinal reattachment with SINGLE surgery was achieved in 52 of 53 eyes (98.2%) and final reattachment rate was 100%. Final visual acuity improved in 46/53 eyes (87%), was unchanged in 6 eyes (11.2%) and worse in 1 patient (1.8%). Postoperative complications included early vitreous hemorrhage in 3 eyes needing repeat PPV for vitreous hemorrhage wash-out combined with cataract surgery (5.6%), late postoperative vitreous hemorrhage needing repeat PPV in 1 eye (1.8%), late secondary rhegmatogenous retinal detachment with proliferative vitreoretinopathy 4.5 months after successful reattachment in 1 eye (1.8%). No neovascular glaucoma or phthisis/NLP vision was noted postoperatively.
Conclusions :
Patients with diabetic TRD at CCHHS present with more complex retinal pathology, yet our surgical outcomes in the newly established vitreoretinal service compare favorably to previously reported series.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.