Total en bloc excision: a modified vitrectomy technique for proliferative diabetic retinopathy

Area of Science:

• Ophthalmology
• Surgical Innovation

Background:

• Proliferative diabetic retinopathy (PDR) is a severe complication of diabetes.
• Vitrectomy is a standard surgical treatment for PDR, but can be associated with complications.

Purpose of the Study:

• To describe and evaluate a modified vitrectomy technique for PDR.
• To assess the safety and efficiency of this novel surgical approach.

Main Methods:

• An interventional case series was conducted.
• The modified technique involves core vitrectomy, glial ring separation, and peeling of the posterior hyaloid membrane without creating a window.
• Membrane delamination is performed at strong vitreoretinal adhesion sites.

Main Results:

• The modified technique was applied to 18 eyes.
• Iatrogenic retinal breaks occurred less frequently compared to the conventional technique (48 eyes), though not statistically significant.
• Surgical time was significantly reduced with the modified technique (P =.0003).
• Effective separation of the glial ring and proliferative tissue was achieved.

Conclusions:

• The modified vitrectomy technique is a viable alternative for PDR surgery.
• This technique may offer advantages in terms of reduced surgical time and potentially fewer complications.