Abstract
Over the recent years, retina specialists have enjoyed significant improvements in the surgical management of proliferative diabetic retinopathy including improved preoperative planning, vitreoretinal instrumentation and new surgical maneuvers. In this review, we present new tips and tricks such as preoperative pharmacotherapy approaches including pegaptanib injection and biodegradable dexamethasone implantation, bimanual vitrectomy techniques and the concept of mixing small gauges as well as valved cannulas and intraoperative optical coherence tomography. With advanced surgical planning and sophisticated operative maneuvers tailored to the individual patient, excellent outcomes can be achieved even in severe cases of diabetic tractional detachment.
Highlights
The global epidemic of diabetes is a significant challenge for public health and ophthalmology in particular
Rubeosis iridis or neovascular glaucoma can represent a surgical indication in select cases with media opacity, this is less commonly performed in the era of anti‐vascular endothelial growth factor (VEGF) agents.[13]
We demonstrated that 5 years prior to diabetic vitrectomy, 39% of patients have already suffered a stroke, 28% a heart attack, and 43% developed renal failure.[22]
Summary
The global epidemic of diabetes is a significant challenge for public health and ophthalmology in particular. PDR Surgery; Oellers and Mahmoud surgery was found in type 1 diabetics, who tended to be younger and had more severe disease.[7] The DRVS established the surgical indication for severe fibrovascular proliferation.[8,9] Tractional retinal detachment (TRD) involving or threatening the macula represents another primary surgical indication.[10,11,12] Other less common indications for vitrectomy are ghost‐cell glaucoma, dense premacular hemorrhage and macular edema with tractional component.
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