July 2019
Volume 60, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2019
Beneficial visual outcome of vitrectomy and delamination surgery in a cohort of black patients
Author Affiliations & Notes
  • Jason Ho
    Ophthalmology, St Thomas' Hospital, London, United Kingdom
  • Alistair Laidlaw
    Ophthalmology, St Thomas' Hospital, London, United Kingdom
  • Footnotes
    Commercial Relationships   Jason Ho, None; Alistair Laidlaw, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 6558. doi:
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      Jason Ho, Alistair Laidlaw; Beneficial visual outcome of vitrectomy and delamination surgery in a cohort of black patients. Invest. Ophthalmol. Vis. Sci. 2019;60(9):6558.

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

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Purpose : Poor outcomes of black patients with proliferative diabetic retinopathy (PDR) have been reported following vitrectomy and delamination of fibrovascular membranes. We aim to report the visual and anatomical outcomes of vitrectomy and delamination surgery for tractional complications of proliferative diabetic retinopathy (PDR) in a cohort of black patients, and to investigate factors that predict visual change.

Methods : Retrospective consecutive case review of all black patients who underwent vitrectomy and delamination surgery for complications of PDR between July 2010 and September 2017.
The primary outcome measure was the change in visual acuity (VA) at 6 months post-operatively. Success was a gain of 0.3 LogMAR and visual loss was a decline of 0.3 LogMAR. Multiple linear regression analysis was performed to evaluate determinants of change in VA.

Results : 44 eyes of 44 patients were included in the analysis. The mean age was 53.7 (range: 24.3 – 75.8) years and 43% were male. Over 52% of patients in our cohort had adjunctive pre-operative anti-VEGF therapy. The mean pre-operative VA was 1.49 LogMAR (SD 0.73), and the mean change in VA was a gain of 0.59 LogMAR ± 0.94 (SD) at six months. Four cases required further vitrectomy to treat rhegmatogenous detachment. 30 cases (68%) achieved visual success. Silicone oil was used as primary tamponade in 3 cases (7%) and as a secondary tamponade in a further 7% of patients. Oil was retained at six months in 4/44 (9%) of cases. Multiple linear regression analysis found that the use of silicone oil was a significant predictor of decline in VA at 6 months (p=0.036).

Conclusions : The majority of our black patient cohort derived visual benefit from vitrectomy and delamination for PDR-related complications. The improvement in VA was comparable to published outcomes from the UK National Ophthalmic Database report. Silicone oil should be avoided in this group if possible and our results suggest that low rates of oil tamponade are possible if surgery is augmented by pre-operative adjunctive intravitreal bevacizumab.

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.


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