Pars plana vitrectomy and silicone oil injection in proliferative diabetic retinopathy

Abstract

A retrospective study is reported on 106 eyes with proliferative diabetic retinopathy, treated by vitrectomy and silicone oil injection. Indications were traction detachment in 91 eyes and nonclearing rebleeding in 15 eyes; 31 eyes had previously had vitrectomy. Anatomical success was obtained at the end surgery in 91 eyes, and after a minimum follow-up of 6 months in 68 eyes (64%). Functional results were as follows: satisfactory visual acuity (0.5-0.05) in 23 eyes (22%), ambulatory vision (0.03-CF) in 14 eyes (13%), HM-LP in 54 eyes (51%), and NLP in 15 eyes (14%). The functional results are limited by recurrent detachments due to characteristic reproliferations under the silicone bubble or by ischemic diabetic angiopathy in the attached retina. A positive effect of silicone oil is demonstrated in the reduction of preexisting or postoperatively new iris neovascularization and in preventing postoperative rebleeding.

Outcomes of vitrectomy in severe complications of proliferative diabetic retinopathy

“…The incidence of recurrent VH in PDR was reported in 13-54% of cases [4][5][6][7]; in our study this incidence was 11%.…”

“…Since then, the surgical instrumentation has been permanently improved. In 2005, Eckardt developed the 23 G instrumentation [4]. Vitrectomy instruments are now available also in 25 and 27 gauge, which are better for navigation.…”

Neovascular Glaucoma – A Review

“…3 On the other hand, intraocular silicone oil decreases the incidence of rubeosis iridis. 4 Cataract surgery can also lead to progression of Diabetic retinopathy (DR). An intact posterior capsule reduces the risk.…”

Postoperative Komplikationen nach Silikonölinstillation

“…Jedoch beobachteten wir bei Diabetikern nach der Silikonolentfernung eine Zunahme der Rubeosis and eine Verschlechterung des Neovaskularisationsglaukoms. Mehrere Autoren zeigten, daB die Silikonoltamponade bei der proliferativen diabetischen Retinopathie neben der Prevention des Neovaskularisationsglaukoms auch einen positiven Einfluss auf eine bereits vorbestehende Rubeosis oder ein Neovaskularisationsglaukom hat [7,11,14].…”