Early vitrectomy may prevent further vision loss in proliferative diabetic retinopathy
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FORT LAUDERDALE, Fla. — Early pars plana vitrectomy may be a low-cost, definitive treatment for patients with proliferative diabetic retinopathy, according to a speaker at the Retina World Congress.
Francesco Boscia, MD, said the indications for early vitrectomy have traditionally been in patients at high risk for threatened vision, including those with dense premacular vitreous hemorrhage, traction macular detachment and other complications.
“This was mainly due to the risk of surgery in the era of 20 gauge and the cost related to possibly multiple surgical approaches,” he said.
Boscia said the retina community has recently come to understand that even under the best circumstances, treatments such as panretinal photocoagulation or ranibizumab therapy are not always effective at preventing progression of proliferative diabetic retinopathy (PDR) and the necessity of vitrectomy.
Advances in small-gauge early vitrectomy have provided surgeons with better tissue separation and more control, Boscia said.
In a recent study, Boscia and colleagues looked at 38 patients who underwent early vitrectomy for PDR and observed a clinically significant progression in visual acuity, a result that was in line with other recent studies, he said.
“There is a significant rate of subsequent treatments with initial laser or intravitreal anti-VEGF, and this combined with the low degree of compliance of this population actually support the approach with an early vitrectomy for diabetic retinopathy,” Boscia said. “[Early vitrectomy] might be a definitive treatment for PDR, preventing further visual loss.”
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Boscia F. Early pars-plana vitrectomy for complications for proliferative diabetic retinopathy. Presented at: Retina World Congress; May 12-15, 2022; Fort Lauderdale, Fla.
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