Results and prognostic factors in vitrectomy for diabetic traction retinal detachment of the macula

The level of final visual acuity results and the prognostic factors predictive of the level were analyzed in 360 eyes that had pars plana vitrectomy for diabetic traction retinal detachment of the macula. Fifty-nine percent of the eyes had improved visual acuity on final examination. The percentage of eyes that achieved a final visual acuity of 20/100 or better and the percentage that achieved 5/200 or better increased from 21% to 36% and from 57% to 72%, respectively, during the study. Preoperative factors associated with a favorable visual prognosis were a visual acuity of 5/200 or better, the absence of iris neovascularization, a clear crystalline lens or only minimal cataract formation, clear media or only mild vitreous hemorrhage, panretinal photocoagulation of at least one fourth of the retina, and the absence of severe preoperative retinal neovascularization. Intraoperative factors associated with a favorable visual prognosis include the avoidance of performing a lensectomy, the absence of iatrogenic retinal breaks, and the avoidance of using intraocular gas bubbles.