[Pars-plana vitrectomy in diabetic traction retinal detachments with holes]

To evaluate results and prognostic factors of pars-plana vitrectomy (ppv) using membrane peeling and C2F6-gas for diabetic traction retinal detachments with a hole.

We retrospectively reviewed the healing course of 84 eyes, which were treated in this way consecutively (follow-up 6-32 month). C2F6 was always used in case of a retinal hole at the posterior pole or in the upper part of the eye. The influence of HBA1c, type of diabetes, preoperative visual acuity, preoperative laser-coagulation and macular status over treatment results and rate of complications were studied using multivariate logistic regression analysis.

Preoperatively 56% of the eyes showed premacular vitreous hemorrhage and 69% macular detachment. Using on an average 1.3 treatments in 73% retina was completely reattached and in 85% visual acuity remained unchanged or improved. The most important prognostic factors were HBA1c < 9.3, type II diabetes and bad vision preoperatively. Postoperative complications such as rubeosis, secondary glaucoma and repeated vitreous hemorrhages were more frequent in case of type I diabetes, HBA1c > or = 9.3 and insufficient laser treatment.

Best corrected blood sugar levels preoperatively and sufficient laser treatment seem to be very important to decrease the risk for rubeosis and repeated vitreous hemorrhages especially for patients with type I diabetes.