Study investigates complications of PPV for diabetic tractional retinal detachment
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NEW YORK — A study found a 46.4% incidence rate of vitreous hemorrhage after 27-gauge pars plana vitrectomy for diabetic tractional retinal detachment, with spontaneous resolution in nearly half of the cases.
The results were presented in a poster by Xiaoyu Cai and co-authors at the American Society of Retina Specialists annual meeting.
The retrospective review included 110 eyes of 87 patients that underwent 27-gauge pars plana vitrectomy (PPV) for diabetic tractional retinal detachment by a single surgeon. Vitreous hemorrhage (VH) occurred in 51 eyes (46.4%) and cleared spontaneously in 25 (49%) of those eyes within 4 months on average. Persistent nonclearing VH was found in 26 eyes, 14 (53.8%) of which required reoperation.
Several preoperative, perioperative and postoperative variables were analyzed to find potential associations with postoperative VH, nonclearing VH and reoperation. The only significant association was between nonclearing VH and preoperative total detachment of the retina. A borderline association was found between nonclearing VH and the use of intraoperative pressors, as well as postoperative ocular hypertension. Higher HbA1c also seemed mildly associated with a decreased likelihood of reoperation for nonclearing postoperative vitreous hemorrhage.
“Twenty-seven-gauge PPV has been increasingly utilized in more complex operations, with treatment of diabetic tractional retinal detachment being one of the most challenging procedures given the involvement of thick, adherent tractional membranes and friable retina,” the authors wrote. “Further analysis is required to elucidate potential risk factors that may predict VH development and characteristics after 27-gauge PPV treatment of diabetic tractional retinal detachment.”
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Cai X, et al. Vitreous hemorrhage following 27-gauge pars plana vitrectomy for diabetic tractional retinal detachment. Presented at: American Society of Retina Specialists annual meeting; July 13-16, 2022; New York.
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