Abstract
Aim:To review the literature relating to diabetic vitrectomy, providing an update on topics where new information is available.Method:Reference to articles in peer-reviewed journals, the minutes of international academic meetings and authoritative textbooks.Results:We discuss aspects of management that will assist the vitreoretinal surgeon in evidence-based decision-making, including indications and timing of surgery, the use of pharmacological adjuvants, the influence of lens status, choice of vitrectomy gauge and the use of tamponades.Conclusions:Improvements in safety and outcome from diabetic vitrectomy have led a trend towards earlier surgery. A growing body of evidence supports the role of vitrectomy in diabetic macular oedema in the presence of traction. Anti-vascular endothelial growth factor (anti-VEGF) may aid surgery, but the risk of progression of tractional retinal detachment should be considered. The evidence for the efficacy of other adjuvants is discussed. We examine the role of cataract surgery in diabetic vitrectomy, discuss the use of tamponades and recommend a pragmatic approach when selecting a vitrectomy gauge.
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