Analysis of surgical outcomes of vitrectomy for severe proliferative diabetic retinopathy with retinal detachment

Objective To analyze surgical outcomes of vitrectomy for severe proliferative diabetic retinopathy(PDR) with retinal detachment.Design Retrospective case series.Participants 95 eyes of 87 patients with severe PDR stage Ⅵ,which underwent vitrectomy from March 2004 to March 2007.Methods The clinical data of 95 eyes of 87 patients with severe PDR were retrospectively analyzed.The mean follow up time was 26 months.The visual acuity and postoperative complications were recorded and the factors associated with visual acuity prognosis were analyzed.Main Outcome Measures The visual acuity and complications after vitrectomy.Results The retina got anatomic reattachment in 83 eyes(87%).The visual acuity after vitrectomy improved in 44 eyes(46.3%),unchanged in 16 eyes(16.8%) and decreased in 35 eyes(36.8%).The difference of visual acuity before and after surgery was statistically significant(P=0.012).Retina detachment involved the macula in 60 eyes.Visual acuity decreased in 45% of these eyes after vitrectomy.After surgery,neovascular glaucoma happened in 7 eyes(7.4%),corneal endothelium cell loss happened in 1 eye(1.1%),and lens opacity progressed in 52 eyes(54.7%).Conclusion Vitrectomy is effective for severe PDR with retinal detachment,and whether the retinal detachment involving the macula is the most important factor for visual acuity prognosis.