[Long-term vision follow-up after vitrectomy in diabetic retinopathy]

We investigated whether visual acuity remained stable in the long run after vitrectomy for complications of diabetic retinopathy and which risk factors for a decrease in vision could be identified.

The charts of 389 patients who had undergone vitreous surgery for complications of diabetic retinopathy between 1990 and 1994 were retrospectively reviewed. The median follow-up was 26 months with a minimum of 6 months.

Seventy-two percent of the eyes with a vision of 20/200 or better within 6 months after surgery retained this vision after 2 years. The percentage of eyes with vision of less than 5/200 was 25% after 6 months and increased to 41% after 4 years. After 2 years 24% of the eyes had lost two or more lines compared to the best vision within the first 6 months after surgery. The main cause for a decrease of vision in type-I diabetics was retinal detachment, in type-II diabetics a progression of maculopathy and opticopathy. Risk factors for a detachment were pre-existing retinal detachment before surgery and reduced postoperative vision. The risk factor for a progression of maculopathy and opticopathy was a silicone tamponade.

Eyes with good vision soon after surgery remain stable in the long run. Eyes with advanced stages of diabetic retinopathy and only ambulatory vision after surgery have an increased risk for new loss of visual function in the long run.