Different intraocular tamponade during vitrectomy on proliferative diabetic retinopathy

Objective To study the effect of different intraocular tamponade during vitrectomy on proliferative diabetic retinopathy.Methods Retrospective analysis was taken at the visual outcome,retina reattached rate,the development of iris neovascularization,postoperative cataract and postoperative vitreous hemorrhage of 451 consecutive patients(536 eyes) who underwent vitrectomies for proliferative diabetic retinopathy.Results Preoperative or iatrogenic retinal breaks or not were chosen as one major factor of the intraocular tamponade indications.The total rate of attached retina was 92.54%.Irrigating solutions group showed better outcome than other groups:visual acuity improvement in 76.42%,retina reattachment in 92.00%,rubeosis iridis in 2.78% and cataract in 8.11%.There was no statistical significance in the reattachment rate of retina between irrigating group and the total of other tamponade groups(P=0.055);Mild postoperative vitreous hemorrhage happened most often in all the three groups and the rehemorrhage rate of the tamponade gas group was the lowest (10.14%).Conclusion Whether there are preoperative or iatrogenic retinal breaks is important for choosing intraocular tamponade during the vitrectomy on proliferative diabetic retinopathy eyes.Proliferative diabetic retinopathy Ⅵ stage was not the indication to choose tamponade.Improving the operative skills and the absence of the iatrogenic retinal breaks can avoid the abuse of gas or silicone oil,which may avoid the tamponade complications and the dislodgement of tamponade at the second operation.