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Modified vitrectomy may be viable alternative for proliferative DR

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SAITAMA, Japan — A modified vitrectomy technique for proliferative diabetic retinopathy may be an appropriate surgical alternative to conventional techniques, according to a small study.

Akihiro Kakehashi, MD, of the Omiya Medical Center here at the Jichi Medical School, performed a modified vitrectomy on 18 eyes with proliferative diabetic retinopathy (DR). In the modified technique, Dr. Kakehashi performed a core vitrectomy, followed by separation of the glial ring from the optic disc using a hook or forceps. The posterior hyaloid membrane was lifted and peeled from the posterior to the peripheral retina without creating a window in the posterior hyaloid membrane. At any strong adhesion site, the posterior hyaloid was partially removed, followed by membrane delamination.

In the 18 eyes that underwent the modified procedure, iatrogenic retinal breaks occurred less often compared with the 48 eyes that underwent the conventional technique. The authors noted that this difference was not statistically significant, although the surgical time was significantly reduced.

The study is published in the November issue of American Journal of Ophthalmology.