Investigative Ophthalmology & Visual Science Cover Image for Volume 58, Issue 8
June 2017
Volume 58, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2017
The Effect of Tamponade Agent on the Visual and Anatomical Outcome of Vitrectomy in Diabetic Tractional Retinal Detachment
Author Affiliations & Notes
  • Hossein Ameri
    USC Roski Eye Institute, Keck School of Medici, University of Southern California, Los Angeles, California, United States
  • Philip Storey
    USC Roski Eye Institute, Keck School of Medici, University of Southern California, Los Angeles, California, United States
  • Anna Ter-Zakarian
    USC Roski Eye Institute, Keck School of Medici, University of Southern California, Los Angeles, California, United States
  • Shannon A Philander
    USC Roski Eye Institute, Keck School of Medici, University of Southern California, Los Angeles, California, United States
  • Lisa C Olmos
    USC Roski Eye Institute, Keck School of Medici, University of Southern California, Los Angeles, California, United States
  • Meena George
    USC Roski Eye Institute, Keck School of Medici, University of Southern California, Los Angeles, California, United States
  • Mark S Humayun
    USC Roski Eye Institute, Keck School of Medici, University of Southern California, Los Angeles, California, United States
  • Damien C Rodger
    USC Roski Eye Institute, Keck School of Medici, University of Southern California, Los Angeles, California, United States
  • Footnotes
    Commercial Relationships   Hossein Ameri, None; Philip Storey, None; Anna Ter-Zakarian, None; Shannon Philander, None; Lisa Olmos, None; Meena George, None; Mark Humayun, None; Damien Rodger, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2017, Vol.58, 5037. doi:
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      Hossein Ameri, Philip Storey, Anna Ter-Zakarian, Shannon A Philander, Lisa C Olmos, Meena George, Mark S Humayun, Damien C Rodger; The Effect of Tamponade Agent on the Visual and Anatomical Outcome of Vitrectomy in Diabetic Tractional Retinal Detachment. Invest. Ophthalmol. Vis. Sci. 2017;58(8):5037.

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

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Abstract

Purpose : To evaluate the effect of tamponade agent on the visual and anatomical outcome of diabetic tractional retinal detachment (TRD) repair.

Methods : Operative records were used to identify all patients with TRD secondary to proliferative diabetic retinopathy surgically repaired between November 1, 2009 and January 1, 2015 at the LAC + USC (Los Angeles County + University of Southern California) Medical Center. Primary outcomes were retinal attachment status and best corrected visual acuity (BCVA) at final follow-up.

Results : A total of 403 eyes with diabetic TRD in 358 patients were included. Average patient age at surgery was 49.6 years (range 26.2-68.7 years).
Tamponade agent choice was: none 36.7%, air 7.4%, SF6 8.4%, C3F8 23.1%, silicone oil (SO) 24.3%. Compared to TRD’s treated without a tamponade agent or with air/gas tamponade, TRD’s treated with SO tamponade were more likely to be macula involving (74.5% vs. 55.4%; p=0.001), have a concurrent RRD (47.0% vs. 12.8%; p<0.0001), and have worse pre-op BCVA (1.89 vs. 1.68; p=0.0026).
Single surgery and final anatomical success rate based on tamponade agent was: none 89.9% and 93.9, air 93.3% and 93.3%, SF6 94.1% and 94.1%, C3F8 90.3% and 96.8%, and SO 77.6% and 85.7% respectively. SO tamponade was associated with a significantly lower rate of anatomical success with single surgery (p=0.013) and at final follow up (p=0.048)
For eyes treated with SO, visual acuity stabilized or improved in 65.3% of cases compared to 85.2% of cases treated with air, gas, or no tamponade (p<0.0001).

Conclusions : In this retrospective study of vitrectomy for diabetic TRD, SO tamponade was associated with a less favorable anatomical and visual outcome compared to air, SF6, C3F8 or no tamponade. However, patients who received SO had a worse pre-op TRD and BCVA.

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.

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