EARLY POSTOPERATIVE INTRAOCULAR PRESSURE STABILITY AFTER COMBINED 23-GAUGE SUTURELESS VITRECTOMY AND CATARACT SURGERY IN PATIENTS WITH PROLIFERATIVE DIABETIC RETINOPATHY

Retina ◽  
2012 ◽  
Vol 32 (9) ◽  
pp. 1767-1774 ◽  
Author(s):  
Jong Yeon Lee ◽  
Hoon Seok Jeong ◽  
Dae Yeong Lee ◽  
Hee Jin Sohn ◽  
Dong Heun Nam
2014 ◽  
Vol 233 (2) ◽  
pp. 104-111 ◽  
Author(s):  
Grant Guthrie ◽  
Henry Magill ◽  
David H.W. Steel

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.


2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Theonitsa Panagiotoglou ◽  
Miltiadis Tsilimbaris ◽  
Harilaos Ginis ◽  
Nikos Karyotakis ◽  
Vaggelis Georgiou ◽  
...  

Purpose.To compare ocular rigidity (OR) and outflow facility (C) in patients with nonproliferative diabetic retinopathy (NPDR) and control subjects.Methods. Twenty-four patients with NPDR (NPDR group) and 24 controls (control group) undergoing cataract surgery were enrolled. NPDR group was further divided into patients with mild NPDR (NPDR1-group) and patients with moderate and/or severe NPDR (NPDR2-group). After cannulation of the anterior chamber, a computer-controlled device was used to infuse saline and increase the intraocular pressure (IOP) in a stepping procedure from 15 to 40 mmHg. Ocular rigidity and outflow facility coefficients were estimated from IOP and volume recordings.Results. Ocular rigidity was 0.0205 μL−1in NPDR group and 0.0202 μL−1in control group (P=0.942). In NPDR1-group, OR was 0.017 μL−1and in NPDR2-group it was 0.025μL−1(P=0.192). Outflow facility was 0.120 μL/min/mmHg in NPDR-group compared to 0.153 μL/min/mmHg in the control group at an IOP of 35 mmHg (P=0.151). There was no difference in C between NPDR1-group and NPDR2-group (P=0.709).Conclusions. No statistically significant differences in ocular rigidity and outflow facility could be documented between diabetic patients and controls. No difference in OR and C was detected between mild NPDR and severe NPDR.


2018 ◽  
Vol 2018 ◽  
pp. 1-11 ◽  
Author(s):  
Jinglin Cui ◽  
Hong Chen ◽  
Hang Lu ◽  
Fangtian Dong ◽  
Dongmei Wei ◽  
...  

Introduction. To compare the effect and safety of intravitreal conbercept (IVC), intravitreal ranibizumab (IVR), or intravitreal triamcinolone acetonide (IVTA) injection on 23-gauge (23-G) pars plana vitrectomy (PPV) for proliferative diabetic retinopathy (PDR). Methods. Fifty patients (60 eyes) of varying degrees of PDR were randomly grouped into 3 groups (1 : 1 : 1) (n=20 in each group). The 23-G PPV was performed with intravitreal conbercept or ranibizumab injection 3–7 days before surgery or intravitreal TA injection during surgery. The experiment was randomized controlled, with a noninferiority limit of five letters. Main outcome measures included BCVA, operation time, incidence of iatrogenic retinal breaks, endodiathermy rate, and silicone oil tamponade. Results. At 6 months after surgery, there were no significant differences of BCVA improvements, operation time, incidence of iatrogenic retinal breaks, endodiathermy rate, silicone oil tamponade, vitreous clear-up time, and the incidence of intraoperative bleeding between the IVC and IVR groups (all P values ≥ 0.05), but they were significantly different from the IVTA group (all P values < 0.05). IOP increases did not show significant differences between the IVC and IVR groups, but both were significantly different with the IVTA group. More patients had higher postoperative IOP in the IVTA group. Conclusions. The intravitreal injection of conbercept, ranibizumab, or TA for PDR had a significant different effect on outcomes of 23-G PPV surgery. Conbercept and ranibizumab can reduce difficulty of the operation, improve the success rate of PPV surgery, and decrease the incidence of postoperative complications.


2020 ◽  
Author(s):  
Rehana Khan ◽  
Janani Surya ◽  
Ramachandran Rajalakshmi ◽  
Padmaja Kumari Rani ◽  
Giridhar Anantharaman ◽  
...  

Introduction: To report the 10 - year rate of vitrectomies and the associated factors in people with proliferative diabetic retinopathy (PDR) from a multicentric cohort of people with diabetes mellitus. Methods: Ten centres in India with established vitreoretinal services for over 10 years were invited to provide long-term data on PDR. People with Type 1 or 2 diabetes with a clinical diagnosis of active PDR in one or both eyes were included. Baseline data collected included age, sex, duration of diabetes, source of referral and best-corrected visual acuity and diabetic retinopathy status in both eyes. Available follow-up data included the numbers of panretinal photocoagulation (PRP) sessions, cataract surgery, treatment of diabetic macular edema, use of anti- vascular endothelial growth factor therapy, vitrectomy with or without retinal surgeries over 10 years. Results: Over 10 years, 89 % needed supplemental PRP after initial complete PRP. One – third required retinal surgery, 16 % needed intravitreal injection. Men (74.5%) had significant higher risk for vitreous surgery. Of the group with low risk PDR, 56.8% did not require vitreoretinal surgery, p <0.001. Of the patients who underwent cataract surgery and had intravitreal anti-VEGF injections, 78.5% and 28.2% needed subsequent vitreous surgery (VR), p=0.006 and <0.0001 respectively. Independent predictors of need for vitreo-retinal surgery included those who underwent cataract surgery and those with poor baseline visual acuity (logMAR). Eyes at lower risk for VR surgery included the eyes previously treated with PRP and low-risk PDR at baseline. Conclusion: Despite initial ‘complete’ PRP, one third of our study cohort needed vitrectomies over 10 years, highlighting that these patients require regular follow-up for a long period of time.


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