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Megan Nichols, Rebecca M Sieburth, Yevgeniy Shildkrot; Outcomes of 27-gauge pars plana vitrectomy for diabetic vitreoretinal disease. Invest. Ophthalmol. Vis. Sci. 2018;59(9):884.
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To evaluate the safety and efficacy of 27-gauge pars plana vitrectomy in cases of proliferative diabetic retinopathy requiring surgical interventions for nonclearing vitreous hemorrhage or tractional retinal detachments in eyes with preoperative visual acuity of 20/200 or worse.
The charts of all patients who underwent a 27-gauge vitrectomy by a single retinal surgeon at the University of Virginia Hospital (UVA) between July 1 2016 and July 1 2017 were retrospectively reviewed. Those patients who underwent 27-gauge vitrectomy with specific indication for intervention related to diabetic retinal disease were selected for study inclusion. Patients who had a pre-operative visual acuity better than 20/200 and patients who were unable to maintain a minimum follow up of 60 days were excluded. Primary outcome measures included change in visual acuity as well as intraoperative and postoperative complications.
Of the 45 patients who underwent 27-gauge vitrectomy during the designated study period, 16 met study inclusion criteria. All eyes included had proliferative diabetic retinopathy with vitreous hemorrhage. There were 10 cases of diabetic tractional retinal detachment and an additional 2 cases requiring extensive membrane peeling. Eight eyes demonstrated improvement in visual acuity after the 60th postoperative day. Four of the 51 sclerotomy sites needed suture placement for closure; three of these were in one eye requiring conversion to the 23-gauge system. Post-operative complications included ocular hypertension in 6 eyes and vitreous hemorrhage in 5 eyes. Of the eyes with recurrent vitreous hemorrhage, 3 were self limiting. During the 60-day post-operative period, one eye developed a focal temporal retinal detachment. There were no cases of post-operative hypotony. There were no cases of post-operative endophthalmitis
The 27-gauge vitrectomy system provides a viable means of surgically approaching the complexities encountered in visually significant diabetic vitreoretinal pathology.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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