Surgical Management of High Risk Proliferative Diabetic Retinopathy: Vitreous Hemorrhage, Tractional Retinal Detachment, and Combined Tractional-Rhegmatogenous Retinal Detachment

The Early Treatment Diabetic Retinopathy Study (ETDRS) was a randomized clinical trial involving nearly four thousand diabetic patients with early proliferative retinopathy, moderate to severe nonproliferative retinopathy, and/or diabetic macular edema in each eye. This paper (ETDRS report number 17) describes the baseline previtrectomy characteristics, initial treatment assignments, indications for vitrectomy, and visual outcomes in the subgroup of patients in the ETDRS who had pars plana vitrectomy (PPV). The study showed that pars plana vitrectomy could improve visual outcomes in patients with complications from proliferative diabetic retinopathy such as vitreous hemorrhage and retinal detachment. PPV continues to play an important role in the management of complications from proliferative diabetic retinopathy.

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Intravitreal pegaptanib in severe proliferative diabetic retinopathy leading to the progression of tractional retinal detachment

Eye ◽

10.1038/eye.2008.179 ◽

2008 ◽

Vol 23 (5) ◽

pp. 1238-1239 ◽

Cited By ~ 10

Author(s):

R Krishnan ◽

S Goverdhan ◽

J Lochhead

Keyword(s):

Diabetic Retinopathy ◽

Retinal Detachment ◽

Proliferative Diabetic Retinopathy ◽

Tractional Retinal Detachment

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Anterior hyaloid membrane dissection using the conventional surgical microscope: a novel surgical approach in 2 patients

International Journal of Retina and Vitreous ◽

10.1186/s40942-019-0191-x ◽

2019 ◽

Vol 5 (1) ◽

Cited By ~ 1

Author(s):

Radwan S. Ajlan ◽

Joey Luvisi

Keyword(s):

Diabetic Retinopathy ◽

Proliferative Diabetic Retinopathy ◽

Surgical Approach ◽

Vitreous Hemorrhage ◽

Tractional Retinal Detachment ◽

Case Presentation ◽

Surgical Microscope ◽

Anatomical Plane ◽

Membrane Dissection ◽

Anterior Proliferative Vitreoretinopathy

Abstract Background To describe the dissection and removal of the anterior hyaloid membrane using the conventional surgical microscope. Case presentation This microscopic surgical approach involves dissecting the anterior hyaloid at the natural anatomical plane. A 30-gauge needle mounted on a 3.0 cc syringe is used to inject filtered air anterior to the anterior hyaloid membrane. Two patients needed this procedure; the first patient was pseudophakic with proliferative diabetic retinopathy, tractional retinal detachment, and vitreous hemorrhage. The second patient was phakic with proliferative diabetic retinopathy, anterior proliferative vitreoretinopathy, and recurrent vitreous hemorrhage. Both patients tolerated the procedure well with no complications. Conclusion Pneumatic dissection of the anterior hyaloid membrane is previously thought to be only possible with the aid of ophthalmic endoscopy. This novel surgical approach provides surgeons with the option to perform pneumatic dissection of the anterior hyaloid when ophthalmic endoscopy is not available. Prospective studies are needed to reveal possible additional benefits or risks associated with this approach.

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