SUPPLEMENTAL DEXTROSE IN THE INFUSION FLUID DURING DIABETIC VITRECTOMY

Area of Science:

• Ophthalmology
• Surgical Innovation
• Diabetic Retinopathy Treatment

Background:

• Historically, dextrose was added to infusion fluid during diabetic vitrectomy to prevent intraoperative lensectomies and maintain visualization.
• Modern surgical techniques, including valved, small-gauge vitrectomy, have reduced surgical time and intraoperative fluid flow.

Purpose of the Study:

• To assess the necessity and impact of supplemental dextrose in infusion fluid during contemporary vitrectomy procedures for diabetic patients.
• To evaluate whether dextrose supplementation affects the rate of intraoperative lensectomies or postoperative cataract development.

Main Methods:

• A retrospective cohort study involving 330 diabetic patients undergoing vitrectomy.
• Patients were divided into two groups: those receiving supplemental dextrose in infusion fluid and those receiving standard balanced salt solution (BSS Plus).
• Tractional retinal detachments were analyzed as a subgroup.

Main Results:

• Supplemental dextrose was used in 199 eyes (60.3%).
• One unplanned lensectomy occurred in the non-dextrose group; rates were not statistically different between groups (P = 0.4).
• Cataract progression showed overlapping survival curves for both groups, including the subgroup with tractional retinal detachments.

Conclusions:

• Unplanned intraoperative lensectomies are rare in modern vitrectomy surgery.
• Supplemental dextrose in infusion fluid does not appear to significantly impact the rate of intraoperative lensectomies or the postoperative cataract course in diabetic patients.
• Standard infusion solutions are likely sufficient for diabetic vitrectomy, negating the need for dextrose supplementation.