Complications and Management of Diabetic Vitrectomy

2012 ◽  
pp. 69-80
Author(s):  
Marco A. Zarbin
Keyword(s):  
Author(s):  
Ogugua N. Okonkwo

Diabetic retinopathy (DR) in its advanced stage is a leading cause of blindness and visual impairment. Despite efforts at early detection of DR, disease monitoring, and medical therapy, significant proportions of people living with diabetes still progress to develop the advanced proliferative disease, which is characterized by neovascularization, actively proliferating fibrovascular membranes, and retinal traction. The surgical removal of this proliferating tissue and the treatment of the retinal ischemic drive can be very rewarding, providing significant stability of the retina and in several cases improved retinal anatomy and vision. Diabetic vitrectomy comprises a broad range of surgical techniques and maneuvers, which offer the surgeon and patient opportunity to reverse deranged vitreoretinal anatomy and improve or stabilizes vision. Advances in vitreoretinal technology have contributed greatly to more recent improved outcomes; it is expected that future advances will offer even more benefit.


Retina ◽  
2010 ◽  
Vol 30 (10) ◽  
pp. 1646-1650 ◽  
Author(s):  
Rizwan A Cheema ◽  
Javed Mushtaq ◽  
Wajeeha Al-Khars ◽  
Essam Al-Askar ◽  
Maheera A Cheema

2009 ◽  
Vol 03 (02) ◽  
pp. 87
Author(s):  
Henry Smith ◽  
Hadi Zambarakji ◽  
◽  

Aim:To review the literature relating to diabetic vitrectomy, providing an update on topics where new information is available.Method:Reference to articles in peer-reviewed journals, the minutes of international academic meetings and authoritative textbooks.Results:We discuss aspects of management that will assist the vitreoretinal surgeon in evidence-based decision-making, including indications and timing of surgery, the use of pharmacological adjuvants, the influence of lens status, choice of vitrectomy gauge and the use of tamponades.Conclusions:Improvements in safety and outcome from diabetic vitrectomy have led a trend towards earlier surgery. A growing body of evidence supports the role of vitrectomy in diabetic macular oedema in the presence of traction. Anti-vascular endothelial growth factor (anti-VEGF) may aid surgery, but the risk of progression of tractional retinal detachment should be considered. The evidence for the efficacy of other adjuvants is discussed. We examine the role of cataract surgery in diabetic vitrectomy, discuss the use of tamponades and recommend a pragmatic approach when selecting a vitrectomy gauge.


2008 ◽  
Vol 146 (2) ◽  
pp. 211-217.e1 ◽  
Author(s):  
Chung-May Yang ◽  
Po-Ting Yeh ◽  
Chang-Hao Yang ◽  
Muh-Shy Chen

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