Recurrent retinal detachment after diabetic vitrectomy

Int Ophthalmol. 2020 Aug;40(8):1931-1939. doi: 10.1007/s10792-020-01366-9. Epub 2020 Apr 15.

Abstract

Purpose: To investigate the characteristics of recurrent retinal detachment (RD) after diabetic vitrectomy (DV).

Methods: Consecutive cases underwent vitrectomy for recurrent RD after DV was collected and separated into the following four groups for analysis: rhegmatogenous RD (RRD), pure tractional RD (Proliferative Subgroup 1), combined RD with proliferative tissue within the equator (Proliferative Subgroup 2), and combined RD with both posterior and peripheral proliferations (Proliferative Subgroup 3).

Results: Of the 41 cases enrolled, retinal reattachment was achieved in 73.2%. Over all, visual acuity was statistically better after operation (p = 0.001). All cases in the RRD group (four cases) had reattachment and a better final vision (p = 0.008). In the proliferative subgroups, those with pure tractional RD (Subgroup 1, seven cases) had the best visual acuity at the time of recurrent RD (p = 0.002). Subgroups 2 and 3 showed statistically significant better final visual acuity (p = 0.045 and 0.019, respectively). Poor preoperative vision (p = 0.001), non-attachment (p = 0.004), and neovascular glaucoma (p = 0.001) were associated with poor prognosis.

Conclusions: Visual acuity may improve after operation for recurrent RD after diabetic vitrectomy. Visual prognosis was better in cases with pure RRD. In the proliferative subgroups, vision was impaired by the development of neovascular glaucoma and retinal non-attachment.

Keywords: Diabetic vitrectomy; Pars plana vitrectomy; Proliferative diabetic retinopathy; Recurrent retinal detachment; Retinal detachment.

MeSH terms

  • Diabetes Mellitus*
  • Humans
  • Retina
  • Retinal Detachment* / diagnosis
  • Retinal Detachment* / etiology
  • Retinal Detachment* / surgery
  • Retrospective Studies
  • Visual Acuity
  • Vitrectomy