The visual outcome of vitrectomy for advanced diabetic retinopathy

The indications for vitrectomy in the management of proliferative diabetic retinopathy are increasing. This is due to the improving results associated with earlier surgery, improving instrumentation and refinements in technique. The current indications for surgery include chronic or recurrent vitreous haemorrhage (of at least one months duration), progressive extramacular tractional retinal detachment, tractional macular detachment and elevated proliferative diabetic retinopathy. This paper reviews a series of 30 vitrectomies performed for severe complications of proliferative diabetic retinopathy. Most favourable visual outcome was associated with surgery for chronic or recurrent vitreous haemorrhage (in the absence of rubeosis iridis) and progressive extramacular tractional retinal detachment. Poor visual prognostic factors were, pre-operative rubeosis iridis and tractional retinal detachments involving the macula.