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