Diabetic vitrectomy is safer and is applicable at an earlier stage of disease

Abstract

Evaluation of: Gupta B, Wong R, Sivaprasad S, Williamson TH. Surgical and visual outcome following 20-gauge vitrectomy in proliferative diabetic retinopathy over a 10-year period, evidence for change in practice. Eye (Lond.) 26(4), 576–582 (2012).

Despite public health advances in earlier diagnosis and treatment of diabetes mellitus, and a more widespread evaluation and treatment of diabetic retinopathy at earlier stages, severe complications requiring surgical intervention still represent a common condition facing vitreoretinal surgeons. The article under review corroborates the prevailing impression that additional experience, relatively earlier intervention, and improved instrumentation have generally let to better results. The authors reported better preoperative vision and better postoperative vision in each successive year of the approximately 10-year interval in which they surveyed the experience at a major teaching hospital in London. All patients underwent 3-port 20-gauge vitrectomy using the en bloc approach. The increased use of local anesthesia reflects faster, less invasive surgical intervention in this subset. They report respectable anatomic and visual results, acknowledge that iatrogenic retinal breaks continue to represent a risk factor for a poorer outcome, and attribute the better postoperative results principally to earlier intervention.

Keywords::

• diabetes mellitus
• diabetic retinopathy
• retinal detachment
• vitrectomy
• vitreous hemorrhage

Financial & competing interests disclosure

The author has no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.