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Vitrectomy for complications of proliferative diabetic retinopathy. Functional outcomes
W E Smiddy1, W Feuer, W D Irvine
1Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami School of Medicine, FL, USA.
Purpose:
To quantitate the effect of diabetic vitrectomy on each patient's visual system and function.
Methods:
The anatomic and visual acuity outcomes of diabetic vitrectomy among three surgeons at one institution over a 4-year time interval were studied. Outcome parameters describing the visual system function were defined and applied to quantitate the effect on visual system disability.
Results:
The anatomic and visual success rates and prognostic factors in the cohort of 213 patients by standard statistical analysis were similar to previous studies. The study eye was the eye with better vision in 68 (32%) patients at the conclusion of the study, and vision was equal to the fellow eye in 35 (16%) patients. The mean impairment of the visual system by the American Medical Association Guidelines for Disability was reduced from 61% preoperatively to 50% postoperatively. The factor associated with greatest degree of reduction of impairment of the visual system was a previtrectomy diagnosis of vitreous hemorrhage. There was at least a one-step improvement of visual system function in 65 (31%) patients.
Conclusions:
Vitrectomy for complications of severe proliferative diabetic retinopathy is especially valuable in improving the patient's overall visual function.