Trimanual vitrectomy versus bimanual vitrectomy in tractional proliferative diabetic retinopathy

Figures & data

Figure 1. Surgical steps of case # 6 (right eye with TRD and ERM of 49-year-old female patient suffering type 1 diabetes for 14 years) in (group A) (A) Injection of the vital dye under the PFCL. (B) Bimanual dissection of fibrovascular membranes. (C) after removal of fibrovascular proliferations.

Figure 2. surgical steps of case # 5 (left eye with TRD and ERM of 51-year-old male patient suffering type 1 diabetes for14 years) in bimanual PPV group (group B): (A) Injection of the vital dye over the posterior pole. (B) Stained fibrovascular proliferations. (C) Bimanual dissection of the preretinal proliferation with intraoperative bleeding.

Table 1. Comparison between the two studied groups according to time of membrane removal and time of surgery.

	Group “A” (n = 20)	Group”B” (n = 20)	t	P
Time of membrane removal (minutes)
Min. – Max.	10.0–16.0	13.0–17.0	2.394*	0.022*
Mean ± SD.	13.35 ± 1.79	14.55 ± 1.36
Median (IQR)	14.0(12.50–14.50)	14.50 (13.0–15.50)
Time of surgery
Min. – Max.	25.0–43.0	30.0–45.0	2.404*	0.021*
Mean ± SD.	31.80 ± 4.32	35.50 ± 5.36
Median (IQR)	30.0(30.0–34.50)	35.0(30.0–40.0)

IQR: Inter quartile rangeSD: Standard deviation t: Student t-test.

p: p value for comparing between Group “A” and Group “B”.

Table 2. Comparison between the two studied groups according to intraoperative bleeding.

Bleeding	Group” A” (n = 20)		Group”B” (n = 20)		χ^2	P
	No.	%	No.	%
No	13	65.0	9	45.0	1.616	0.204
Grade I to Grade II	7	35.0	11	55.0

χ²: Chi square test.

P: p value for comparing between Group A and Group B.

Figure 3. Comparison between the two studied groups according to iatrogenic breaks.

Table 3. Comparison between the two studied groups according to post-operative complication.

Post-operative complication	Group”A” (n = 20)		Group “B” (n = 20)		χ^2	P
	No.	%	No.	%
Early vitreous hemorrhage	(n = 6)		(n = 7)
Grade I	6	100.0	6	85.7	0.929	^FEp= 1.000
Grade II	0	0.0	1	14.3
Inflammation
No	15	75.0	14	70.0	0.125	0.723
Grade I	5	25.0	6	30.0
Increased IOP
No	14	70.0	16	80.0	0.533	0.465
Controlled Medically	6	30.0	4	20.0

χ²: Chi square test FE: Fisher Exact.

p: p value for comparing between Group “A” and Group “B”.

Table 4. Comparison between the different studied periods according to BCVA in each group.

Distance Snellen VA	Preoperative	PO Day 1	PO 1 week	PO 1 month	PO 6 months	Fr	p
Group “A” (n = 20)
Min. – Max.	0.69–2.30	1.0–2.30	0.12–1.85	0.12–1.85	0.12–1.85	55.661*	<0.001*
Mean ± SD.	1.75 ± 0.44	1.95 ± 0.49	0.99 ± 0.42	0.89 ± 0.45	0.73 ± 0.43
Median (IQR)	1.81 (1.77–1.85)	2.30 (1.62–2.3)	1.0 (0.69–1.3)	0.85 (0.69–1.09)	0.69 (0.47–1.0)
p0		0.881	0.001^*	<0.001^*	<0.001^*
Group”B” (n = 20)
Min. – Max.	0.69–2.30	1.0–2.30	0.69–1.85	0.30–1.40	0.39–1.30	61.815*	<0.001*
Mean ± SD.	1.59 ± 0.53	1.81 ± 0.46	1.18 ± 0.34	0.98 ± 0.37	0.82 ± 0.34
Median (IQR)	1.77 (1.3–1.85)	1.77 (1.39–2.3)	1.30 (1.0–1.4)	1.0 (0.69–1.3)	0.69 (0.47–1.12)
p0		0.803	0.002^*	<0.001^*	<0.001^*
p1	0.265	0.369	0.127	0.327	0.314

IQR: Inter quartile range SD: Standard deviation.

Fr: Friedman test, Sig. bet. periods was done using Post Hoc Test (Dunn’s).

PO: postoperative.

p: p value for comparing between the different studied periods in each group.

p₀: p value for comparing between Preoperative and each other periods.

p₁: p value for Mann Whitney test for comparing between Group “A” and Group “B”.

*Statistically significant at p ≤ 0.05.