Pars Plana Vitrectomy: Comparison of Three Techniques for the Treatment of Diabetic Vitreous Hemorrhage

Abstract

To compare the outcome of three vitrectomy techniques in the treatment of diabetic vitreous hemorrhage. The study group included 38 patients (38 eyes) with diabetic vitreous hemorrhage. Three-port pars plana vitrectomy was used in 20 eyes, unimanual vitrectomy with indirect ophthalmoscopy in 10 eyes, and sutureless 25-gauge vitrectomy in 8 eyes. Main outcome measures were operative time, preoperative and postoperative visual acuity and intraocular pressure, and postoperative complications. Mean operative time was 66 minutes for three-port vitrectomy, 35 minutes for indirect vitrectomy, and 40 minutes for 25-gauge vitrectomy. Mean duration of follow-up was 26 months (range = 5 to 43 months). All three techniques successfully treated the vitreous hemorrhage, with similar best-corrected visual acuity outcome and similar complication rates. A greater tendency for hypotony on the first postoperative day was observed in the 25-gauge vitrectomy group. The three major techniques for treating vitreous hemorrhage are similarly effective and yield similar outcomes. The specific technique used should be selected on the basis of the clinical status of the patient and the skills of the surgeon.