Factors influencing surgical results in proliferative diabetic retinopathy

Although the anatomical results of diabetic vitrectomy have been reported to be rather good when silicone oil is used as a tamponade substitute, the functional results remain unsatisfactory. To investigate the factors influencing the functional results in these cases of severe diabetic retinopathy, the correlation between the surgical results and the overall condition of these patients, including the tamponade substitute, was examined. The vitrectomy results obtained in cases of diabetic retinopathy treated using silicone-oil tamponade were studied retrospectively in comparison with those obtained using SF6 gas tamponade or without any tamponade substitute. The visual acuity of more than 80% of eyes belonging to the groups treated with SF6 gas or without any tamponade improved postoperatively, whereas the rate of improvement in the silicone-oil group was limited to low and the postoperative vision ranged widely, since the silicone was usually used in much more severe cases. Iris rubeosis that occurred after pars plana vitrectomy subsided following secondary silicone-oil injection into the vitreous cavity. Only one disadvantage in using silicone oil was that an additional operation was required to remove it, and the visual acuity of nearly 30% of the eyes deteriorated after its removal. As far as the general condition of these patients is concerned, the visual outcome of subjects who had hypoalbuminemia and anemia due to renal dysfunction was poor as compared with that of patients who did not have these disorders. Blood transfusion did not lead to better function.(ABSTRACT TRUNCATED AT 250 WORDS)