Outcome of Bimanual 23G, 5-Ports Versus 3-Ports Pars Plana Vitrectomy for Advanced Diabetic Eye Disease

Abstract

Purpose: Evaluation of efficacy and safety of 23 – guage five ports vitrectomy versus 23 – guage three portspars plana vitrectomy (PPV) in diabetic tractional retinal detachment.Study Design: Prospective Interventional case series.Place and Duration of Study: Mayo hospital and Services hospital, Lahore, from February 2018 to December2018.Material and Methods: Forty eyes of forty patients were equally divided into two groups. One group whichunderwent five ports PPV and the other group had three ports PPV. Patients with tractional retinal detachment(TRD) with fibrovascular membranes were included and patients who had undergone previous ocular surgery(except cataract surgery) or having TRD due to other ocular diseases were excluded. Preoperative work-upincluded visual acuity, intra ocular pressure measurement and slit lamp examination of anterior and posteriorsegment. Gender, age, pre-operative and post-operative BCVA and intraocular pressure presented by calculatingfrequency and percentages.Results: Pre-operative BCVA improved from 1.11 ± 0.5 to 0.66 ± 0.5 in 3-port groups and from 1.7 ± 0.9 to 0.87± 0.8 in 5-port groups. Duration of surgery was 74.40 ± 5.4 and 53.40 ± 2.5 minutes in 3 ports and 5-ports grouprespectively. Iatrogenic retinal tear developed in two patients in each group. Per-operative vitreous hemorrhagedeveloped in three patients in 3-ports group and in two patients in 5-ports group. Two patients in each groupdeveloped post vitrectomy cavity hemorrhage.Conclusion: Bimanual 5- ports 23-guage vitrectomy is a faster procedure than three ports 23 – guage vitrectomyin diabetic tractional retinal detachment.