scholarly journals Comparison of retinal breaks observed during 23 gauge transconjunctival vitrectomy versus conventional 20 gauge surgery for proliferative diabetic retinopathy

2011 ◽  
pp. 109 ◽  
Author(s):  
Sharif Issa ◽  
Allan Connor ◽  
Habib ◽  
David Steel ◽  
Maged S Habib ◽  
...  
Keyword(s):  
Diabetic Retinopathy ◽  
Proliferative Diabetic Retinopathy ◽  
Retinal Breaks ◽  
23 Gauge ◽  
Transconjunctival Vitrectomy

scholarly journals Efficacy and Safety of Intravitreal Conbercept, Ranibizumab, and Triamcinolone on 23-Gauge Vitrectomy for Patients with Proliferative Diabetic Retinopathy

2018 ◽  
Vol 2018 ◽  
pp. 1-11 ◽  
Author(s):  
Jinglin Cui ◽  
Hong Chen ◽  
Hang Lu ◽  
Fangtian Dong ◽  
Dongmei Wei ◽  
...  
Keyword(s):  
Diabetic Retinopathy ◽  
Proliferative Diabetic Retinopathy ◽  
Silicone Oil ◽  
Operation Time ◽  
Intravitreal Ranibizumab ◽  
Intravitreal Triamcinolone ◽  
Retinal Breaks ◽  
Pars Plana ◽  
Silicone Oil Tamponade ◽  
23 Gauge

Introduction. To compare the effect and safety of intravitreal conbercept (IVC), intravitreal ranibizumab (IVR), or intravitreal triamcinolone acetonide (IVTA) injection on 23-gauge (23-G) pars plana vitrectomy (PPV) for proliferative diabetic retinopathy (PDR). Methods. Fifty patients (60 eyes) of varying degrees of PDR were randomly grouped into 3 groups (1 : 1 : 1) (n=20 in each group). The 23-G PPV was performed with intravitreal conbercept or ranibizumab injection 3–7 days before surgery or intravitreal TA injection during surgery. The experiment was randomized controlled, with a noninferiority limit of five letters. Main outcome measures included BCVA, operation time, incidence of iatrogenic retinal breaks, endodiathermy rate, and silicone oil tamponade. Results. At 6 months after surgery, there were no significant differences of BCVA improvements, operation time, incidence of iatrogenic retinal breaks, endodiathermy rate, silicone oil tamponade, vitreous clear-up time, and the incidence of intraoperative bleeding between the IVC and IVR groups (all P values ≥ 0.05), but they were significantly different from the IVTA group (all P values < 0.05). IOP increases did not show significant differences between the IVC and IVR groups, but both were significantly different with the IVTA group. More patients had higher postoperative IOP in the IVTA group. Conclusions. The intravitreal injection of conbercept, ranibizumab, or TA for PDR had a significant different effect on outcomes of 23-G PPV surgery. Conbercept and ranibizumab can reduce difficulty of the operation, improve the success rate of PPV surgery, and decrease the incidence of postoperative complications.

scholarly journals 23-Gauge versus 25-Gauge Vitrectomy for Proliferative Diabetic Retinopathy: A Comparison of Surgical Outcomes

2014 ◽  
Vol 233 (2) ◽  
pp. 104-111 ◽  
Author(s):  
Grant Guthrie ◽  
Henry Magill ◽  
David H.W. Steel
Keyword(s):  
Diabetic Retinopathy ◽  
Proliferative Diabetic Retinopathy ◽  
Transconjunctival Sutureless Vitrectomy ◽  
Retinal Breaks ◽  
Significant Difference ◽  
23 Gauge ◽  
Using Data ◽  
Sutureless Vitrectomy ◽  
25 Gauge Vitrectomy ◽  
Vitrectomy System

Purpose: This study compared clinical outcomes and complications between 23-gauge (23g) and 25-gauge (25g) transconjunctival sutureless vitrectomy in patients with proliferative diabetic retinopathy. Study Design: It was a retrospective study using data prospectively defined and collected. 80 eyes underwent 23g transconjunctival sutureless vitrectomy, and 80 eyes underwent 25g surgery using the same vitrectomy system by one surgeon. Primary outcome measures were best-corrected visual acuity, intraocular pressure (IOP), and incidence of intraoperative and postoperative complications. Results: Vision was significantly improved after intervention in both groups (p ≥ 0.0001). There was no significant difference in visual outcomes between the groups (p = 0.43) or in the type and frequency of retinal breaks occurring during surgery (p = 0.63). The 23g group had significantly more patients with a day 1 IOP of <6 mm Hg (p = 0.034) and significantly more patients requiring a sclerostomy suture postoperatively (p = 0.014). Conclusion and Message: Both gauges are equally effective for the treatment of proliferative diabetic retinopathy.

The method of viscodissection with contrast enhancement of posterior hyaloid membrane for proliferative diabetic retinopathy surgery

2021 ◽  
pp. 127-129
Author(s):  
D.V. Petrachkov ◽  
◽  
A.G. Matyuschenko ◽  
L. Alkharki ◽  
A.L. Sidamonidze ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Diabetic Retinopathy ◽  
Contrast Enhancement ◽  
Proliferative Diabetic Retinopathy ◽  
Vitreoretinal Surgery ◽  
Key Words Diabetes Mellitus ◽  
Key Words Diabetes ◽  
Posterior Hyaloid ◽  
Retinal Breaks

Purpose. Study is to evaluate the efficacy of the method of viscodissection with contrast enhancement of posterior hyaloid membrane in PDR surgery. Material and methods. The study involved 26 patients with type 1 diabetes mellitus and severe PDR with the presence of tractional retinal detachment (TRD). All patients received treatment in the volume of lensectomy and IOL implantation, microinvasive vitrectomy, viscodissection with contrasting of epiretinal structures was performed, followed by segmentation and removal of membranes, endolaser coagulation followed by tamponade with sterile air of the vitreous cavity. Results. In all patients included in the study, with dynamic observation, there was a positive dynamics of morphofunctional indicators - best corrected visual acuity (BCVA) from 32.5-16.1 to 62.2-15.7 and central retinal thickness (CRT) according to optical coherence tomography (OCT) from 775.9-78.4 to 492.1-73.8 µm. Conclusion. The method of viscodissection with simultaneous contrast of the posterior hyaloid membrane facilitates the assessment of the quality of the separation of pathological membranes and improves the quality of visual control over the process of their separation, which reduces the risks of iatrogenic retinal breaks. Key words: diabetes mellitus, proliferative diabetic retinopathy, vitreoretinal surgery, viscodissection.

Outcomes of Surgically Managed Proliferative Diabetic Retinopathy

2018 ◽  
Vol 2 (6) ◽  
pp. 338-342
Author(s):  
Amir Hadayer ◽  
Brett H. Mueller ◽  
Janelle Fassbender Adeniran ◽  
Charles C. Barr
Keyword(s):  
Diabetic Retinopathy ◽  
Proliferative Diabetic Retinopathy ◽  
Vision Loss ◽  
Average Duration ◽  
Vitreous Hemorrhage ◽  
Retrospective Chart Review ◽  
University Of Louisville ◽  
Small Gauge ◽  
23 Gauge

Purpose: The purpose of this article is to conduct a retrospective chart review of the results of vitrectomy for diabetic vitreous hemorrhage (VH) and diabetic traction retinal detachment (TRD) using small-gauge instruments. Methods: We retrospectively reviewed medical records of all diabetic vitrectomies performed at the University of Louisville from 2012 to 2016 that had at least 6 months of follow-up. Patients included in this study underwent pars plana vitrectomy (PPV) for proliferative diabetic retinopathy complications. We analyzed the preoperative and 6- and 12-month postoperative visual acuities (VAs) in patients who had vitrectomy for their diabetic retinopathy. We also determined the proportion of patients who had best-corrected visual acuity (BCVA) of 20/40 or better and 20/80 or worse. In the patients who had BCVA of 20/80 or worse, we identified the reasons for the decreased VA. We also report intraocular pressure, demographic characteristics, operative techniques, and complications. Results: We identified 93 eyes that underwent diabetic vitrectomy; 81 eyes of 63 patients had at least 6 months’ follow-up. Of those 81 eyes, 40 eyes had VH only; the average duration of vision loss before surgery was 4.7 months. Forty-one eyes had TRDs with average duration of vision loss before surgery of 7 months. The presenting BCVA was 1.14 logMAR (20/300) in the VH-only group and 1.49 logMAR (20/600) in the TRD group ( P < .09). Six months after surgery, the BCVA was 0.59 logMAR (20/80) in the VH-only group but still 1.37 logMAR (20/500) in the TRD group ( P < .001). By 12 months after surgery (63 eyes), the BCVA was 0.60 logMAR (20/80) vs 1.09 logMAR (20/250), respectively ( P < .02). Technical success was achieved in 79 of 81 eyes. At 12 months after surgery, 22 eyes (55%) in the VH-only group and 19 eyes (46%) in the TRD group gained 15 letters or more (doubling the VA) compared with their presenting VA. In the VH-only group 7 eyes (18%) were 23-gauge (G) PPV, 22 (58%) were 25G PPV, and 9 (24%) were 27G PPV, while in the TRD group 15 (38%) were 20G PPV, 11 (27%) were 23G PPV, and 14 (35%) were 25G PPV. There was no difference in outcome with different gauges. Conclusions: While vitrectomy for complications of diabetic retinopathy was technically successful with small-gauge surgery, visual results were disappointing. Further work is needed to clarify the best timing of surgery to improve visual outcomes.

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