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Haydarpaşa Numune Eğitim ve Araştırma Hastanesi, 1. Göz Kliniği, İstanbul Purpose: To evaluate the effectiveness and safety of pars plana vitrectomy and membrane peeling with bimanual delamination technique in eyes with severe diabetic fibrovascular proliferation.
Materials and Method: In this retrospective study, 18 eyes of 17patients with traction macular detachment, extramacular retinal detachment threatening the macula, or macular distortion secondary to diabetic fibrovascular proliferation were examined between January 2001 and March 2002. All eyes underwent pars plana vitrectomy and membrane peeling with bimanual delamination technique. Main outcome measures were; initial and final visual acuity, intra and postoperative complications.
Results: Mean age of the patients was 56±11,1 years (27-78 years). Follow-up period was 7,1 ±3,9 months (3-14 months). Fibrovascular proliferation was removed in all eyes and traction retinal detachment reattached. Preoperative visual acuity was between light perception and counting fingers at 5 m; whereas postoperative visual acuity was found to be between hand motions and 5/10. Visual acuity improved in 16 of 18 eyes (88.8%). Of 18 eyes, 10 (55.5%) had preoperative visual acuity of counting fingers at 2 m or less; whereas 6 had postoperative visual acuity of 1/10 or better, latrogenic breaks occured in 4 eyes (22.2%) during delamination. These breaks were observed flat during the follow-up period. In 10 of 16 phakic eyes (62.5%) lens opacities progressed, but only 2 of them required cataract surgery.
Conclusion: Pars plana vitrectomy and membrane peeling with bimanual delamination technique is an effective and safe method in patients with severe diabetic fibrovascular proliferation. Keywords : Diabetic retinopathy, fibrovascular proliferation, pars plana vitrectomy, bimanual delamination technique