Related Experiment Videos
Visual and Anatomical Outcomes After Early Phacovitrectomy for Diabetic Tractional Retinal Detachment Without Macular
Pablo Ángel García-Uribe1, Beatriz J Pérez-Aragón1, Luisa Fernanda Yáñez-Ortega1
1Salauno, Clínica Oftalmológica, Ciudad de México, Mexico.
Background And Objective:
Diabetic tractional retinal detachment (TRD) is an advanced complication of proliferative diabetic retinopathy that may lead to irreversible visual loss. When the macula remains uninvolved, surgical treatment before macular involvement may be clinically relevant. The aim of this study was to describe the 6-month anatomical and visual outcomes of phacovitrectomy performed within 45 days of diagnosis in patients with diabetic TRD without macular involvement and to explore the association between detachment extent and final visual acuity.
Materials And Methods:
This retrospective observational cohort study included patients with diabetic TRD without macular involvement treated with primary phacovitrectomy at a tertiary center between January 2019 and December 2020. Procedures consisted of 25-gauge pars plana vitrectomy combined with phacoemulsification and intraocular lens implantation. Preoperative intravitreal aflibercept was administered 5 to 7 days before surgery in 95% of cases. Primary outcomes were best-corrected visual acuity (BCVA, logMAR) at 6 months and the primary retinal reattachment rate.
Results:
Sixty eyes from 58 patients with a minimum follow-up of 6 months were included. Mean BCVA improved from 1.67 logMAR (approximately 20/935) preoperatively to 0.80 logMAR (approximately 20/126) at 3 months and to 0.62 logMAR (approximately 20/83) at 6 months. Pairwise comparisons showed statistically significant differences between baseline and 3 months (p < 0.001), 3 and 6 months (p < 0.001), and baseline and 6 months (p < 0.001). The primary retinal reattachment rate was 98.3%. No statistically significant association was found between the number of involved quadrants and final BCVA (p = 0.35).
Conclusions:
In this retrospective cohort, phacovitrectomy performed within 45 days of diagnosis in patients with diabetic TRD without macular involvement was associated with a high anatomical reattachment rate and significant functional improvement at 6 months. These findings describe favorable outcomes in this subgroup and support the need for prospective comparative studies evaluating the effect of surgical timing on visual prognosis.
