No abstract

Purpose: This study compared clinical outcomes and complications between 23-gauge (23g) and 25-gauge (25g) transconjunctival sutureless vitrectomy in patients with proliferative diabetic retinopathy. Study Design: It was a retrospective study using data prospectively defined and collected. 80 eyes underwent 23g transconjunctival sutureless vitrectomy, and 80 eyes underwent 25g surgery using the same vitrectomy system by one surgeon. Primary outcome measures were best-corrected visual acuity, intraocular pressure (IOP), and incidence of intraoperative and postoperative complications. Results: Vision was significantly improved after intervention in both groups (p ≥ 0.0001). There was no significant difference in visual outcomes between the groups (p = 0.43) or in the type and frequency of retinal breaks occurring during surgery (p = 0.63). The 23g group had significantly more patients with a day 1 IOP of <6 mm Hg (p = 0.034) and significantly more patients requiring a sclerostomy suture postoperatively (p = 0.014). Conclusion and Message: Both gauges are equally effective for the treatment of proliferative diabetic retinopathy.

Purpose The purpose of this study is to evaluate the efficacy of preoperative intravitreal bevacizumab (IVB) for improving outcomes in vitrectomy for diabetic retinopathy-related non-clearing vitreous haemorrhage and/or tractional retinal detachment. Methods Medical record from patients undergoing vitrectomy for proliferative diabetic retinopathy (PDR) were retrospectively analysed (2003)(2004)(2005)(2006)(2007)(2008)(2009)(2010)(2011). From 2007, IVB (1.25 mg 2-4 days before operating) was used on all eyes. Eyes receiving IVB were compared with those that did not receive IVB. Intraoperative complications, reoperation rates, and final visual acuity were the core outcome measures. Results Data were analysed for 88 patients (101 eyes). In all, 41 (41%) patients had received IVB, whereas 60 (59%) patients had not. Significant intraoperative haemorrhage occurred in six eyes (10%) in the non-IVB group and in one (2.4%) IVB eyes (P ¼ 0.24). Silicon oil was used in 29 (48%) non-IVB eyes and in 11 (27%) IVB eyes (P ¼ 0.03). The non-IVB eyes underwent significantly more vitreoretinal reoperations (P ¼ 0.01) and were significantly more likely to lose two or more lines of vision at the final follow-up (P ¼ 0.03). The numbers needed to treat (NNT) blindness (o3/60) was four for non-IVB eyes and two for the IVB group. Conclusions IVB reduces surgical complications, the use of silicon oil, and the need for further retinal surgery. The NNT to restore useful vision (Z3/60) to a blind eye were significantly lower in the IVB group. Vitreoretinal surgery for the complications of PDR is effective in an East African context, and IVB should be considered a valuable adjunct.