scholarly journals Iatrogenic retinal breaks during 20-gauge vitrectomy for proliferative diabetic retinopathy

2012 ◽  
pp. 29 ◽  
Author(s):  
Yumi Kamura ◽  
Sato ◽  
Yuzo Deguchi ◽  
Yagi
Keyword(s):  
Diabetic Retinopathy ◽  
Proliferative Diabetic Retinopathy ◽  
Retinal Breaks

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.

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.

scholarly journals Potential bias of preoperative intravitreal anti-VEGF injection for complications of proliferative diabetic retinopathy

PLoS ONE ◽  
2021 ◽  
Vol 16 (10) ◽  
pp. e0258415
Author(s):  
Kei Takayama ◽  
Hideaki Someya ◽  
Hiroshi Yokoyama ◽  
Takeshi Kimura ◽  
Yoshihiro Takamura ◽  
...  
Keyword(s):  
Diabetic Retinopathy ◽  
Postoperative Complications ◽  
Proliferative Diabetic Retinopathy ◽  
Real World ◽  
Postoperative Outcome ◽  
Neovascular Glaucoma ◽  
Potential Bias ◽  
Baseline Hba1c ◽  
Anti Vegf ◽  
Retinal Breaks

Purpose Intravitreal anti-VEGF injection (IVI) is administered before vitrectomy to assist management of proliferative diabetic retinopathy (PDR)-related complications. In the clinical setting, retinal surgeons determine the use of preoperative IVI based on individual criteria. In this study, we investigated factors related to the potential bias of retinal surgeons in using IVI prior to vitrectomy for PDR-related complications, and evaluated the real-world outcomes of surgeon-determined preoperative IVI. Methods Medical records of 409 eyes of 409 patients who underwent 25-gauge vitrectomy for PDR complications at seven Japanese centers (22 surgeons) were retrospectively reviewed. Ocular factors, demographic and general clinical factors, surgical procedures, and postoperative complications were compared between IVI group (patients who received preoperative IVI; 87 eyes, 21.3%) and non-IVI group (patients who did not receive preoperative IVI; 322 eyes, 78.7%). In addition, baseline HbA1c in IVI group and non-IVI group was compared between eyes with and without postoperative complications. Results At baseline, IVI group was younger (P<0.001), had shorter duration of diabetes treatment (P = 0.045), and higher frequencies of neovascular glaucoma [NVG] (P<0.001) and tractional retinal detachment [TRD] (P<0.001) compared to non-IVI group. Although IVI group had higher frequencies of intraoperative retinal break and tamponade procedure, there were no significant differences in postoperative complications and additional treatments between two groups. Baseline HbA1c levels were also not correlated with postoperative complications of VH, NVG, and RD both in IVI group and non-IVI group. Logistic regression analysis identified age (P<0.001, odds ratio [OR] 0.95), presence of NVG (P<0.001, OR 20.2), and presence of TRD (P = 0.0014, OR 2.44) as preoperative factors in favor of IVI. Conclusions In this multicenter real-world clinical study, younger age and presence of NVG and TRD were identified as potential biases in using IVI before vitrectomy for PDR complications. Eyes that received preoperative IVI had more intraoperative retinal breaks requiring tamponade than eyes not receiving IVI, but postoperative outcome was not different between the two groups.

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.

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