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Safety and effectiveness of pre-emptive diabetic vitrectomy in patients with severe, non-fibrotic retinal neovascularisation despite panretinal photocoagulation

Eye volume 37, pages 1553–1557 (2023)Cite this article

Subjects

Abstract

Objectives

To investigate the safety and effectiveness of pre-emptive vitrectomy in eyes with severe non-fibrotic proliferative diabetic retinopathy.

Methods

A multi-centre, retrospective, observational study. Pre-emptive vitrectomy was performed in non-fibrotic diabetic eyes with a visual acuity (VA) of 20/50 or better, where there was extensive persistent neovascularisation despite prior panretinal photocoagulation, and where the fellow eye had established sight loss despite vitrectomy for tractional complications. The primary outcome measure was the VA at last visit.

Results

Twenty patients were included. The mean age was 39 ± 14 years. Fifteen patients were Type 1 diabetic. The median baseline VA was 20/30 and remained stable at 20/28 at last visit (median follow-up period: 24 months). Eight eyes (40.0%) developed post-operative vitreous cavity haemorrhage; 4 of which required a vitreous cavity washout procedure. There were no post-operative retinal detachments. The index eye remained the significantly better eye at all time points bar one month post-surgery. Regression of retinopathy grading was observed in all eyes.

Conclusion

In this pilot study, we found no sight loss with pre-emptive diabetic vitrectomy. Better eye status was maintained in this high-risk group. Further study with larger number of patients and longer-term follow-up is indicated.

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Fig. 1
Fig. 2: Pre- and post- operative colour fundal photographs.

Data availability

The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request.

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Funding

The authors received no funding for the study.

Author information

Authors and Affiliations

  1. St Paul’s Eye Unit, Liverpool University Hospitals, Liverpool, UK

    Shi Zhuan Tan

  2. Sunderland Eye Infirmary, Sunderland, UK

    David H. Steel

  3. Biosciences Institute, Newcastle University, Newcastle Upon Tyne, UK

    David H. Steel

  4. Eye Clinic Sulzbach, Knappschaft Hospital Saar, Sulzbach, Germany

    Boris V. Stanzel, Martin Bedersdorfer & Peter Szurman

  5. Tennent Institute of Ophthalmology, Great Western Road, Glasgow, UK

    Shohista Saidkasimova

  6. Department of Ophthalmology, Aalborg University Hospital, Aalborg, Denmark

    Katja Christina Schielke

  7. Department of Ophthalmology, St Thomas’ Hospital, London, UK

    Neruban Kumaran & David Alistair H. Laidlaw

Authors
  1. Shi Zhuan Tan
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  2. David H. Steel
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Contributions

All authors meet the following criteria:1. Conceived and/or designed the work that led to the submission, acquired data, and/or played an important role in interpreting the results. 2. Drafted or revised the manuscript. 3. Approved the final version. 4. Agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

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Correspondence to Shi Zhuan Tan.

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Tan, S.Z., Steel, D.H., Stanzel, B.V. et al. Safety and effectiveness of pre-emptive diabetic vitrectomy in patients with severe, non-fibrotic retinal neovascularisation despite panretinal photocoagulation. Eye 37, 1553–1557 (2023). https://doi.org/10.1038/s41433-022-02167-3

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  • DOI: https://doi.org/10.1038/s41433-022-02167-3

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