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Impressum
Visual Outcome and Vision Limiting Factors after Pars Plana Vitrectomy for Proliferative Diabetic Retinopathy
1Hugger P., 1,2Jonas J. B.
1Department of Ophthalmology and Eye Hospital, Faculty of Clinical Medicine Mannheim, University of Heidelberg, 68167 Mannheim, Germany; 2Department of Ophthalmology and Eye Hospital, University Erlangen- Nürnberg, Erlangen
Objective: Pars plana vitrecomy has become the standard treatment
of tractional retinal detachment due to proliferative diabetic retinopathy.
The purpose of the present study was to evaluate the visual outcome of
patients undergoing pars plana vitrectomy for the disease.
Patients and Methods: The retrospective consecutive clinical interventional
study included 99 patients who consecutively underwent pars plana vitrectomy
for treatment of proliferative diabetic retinopathy. Mean age was 57.2
± 14.1 years, mean preoperative visual acuity was 0.02 ±
0.04 (Lichtschein - 0.25). The three-port pars plana vitrectomy consisted
of a standard procedure with detachment of the posterior vitreous, peeling
of epiretial membranes, and, depending on the clinical situation, of endolaser
coagulation, exocryocoagulation, temporary use of perfluorcarbon liquid,
and silicone oil endotamponade. Main outcome measures were preoperative
and postoperative visual acuity.
Results: Visual acuity improved significantly from 0.02 ±
0.04 preoperatively auf 0.13 ± 0.15 postoperatively. Increase in
visual acuity was on an average 0.10 ± 0.15 (-0.10 - 0.60). Final
visual acuity was higher than or equal to 0.50 in 5 (5%) patients, it
was higher than or equal to 0,25 in 23 (23%) patients, and it was higher
than 0.10 in 44 (44%) patients. Increase in vision was significantly and
negatively correlated with the preoperative visual acuity. Main reason
for reduced visual acuity in the patients with attached reitna at the
end of the study was marked atrophy of the retina and optic nerve.
Conclusions: Pars plana vitrectomy is helpful in increasing visual
acuity in patients with proliferative diabetic retinopathy. Despite a
relatively high rate of anatomic success with the retinae attached the
improvement n visual acuity is limited due to atrophy of the retina and
optic nerve.