Vitrectomy for severe proliferative diabetic retinopathy: a comparison of optical fiber free intravitreal surgery system with traditional vitrectomy

Abstract

To compare the optical fiber free intravitreal surgery system with traditional vitrectomy in eyes with severe proliferative diabetic retinopathy (PDR). 22 eyes of 18 patients with extensive fibrovascular proliferation associated with PDR were undergone vitrectomy using optical fiber free intravitreal surgery system (OFFISS) with bimanual technique, peeling of epiretinal membrane and/or internal limiting membrane, intraocular laser coagulation, air-fluid exchange, tamponading of air and expansive gases or silicon oil were performed according to the condition of diseases. 22 eyes with similar severity of fibrovascular proliferation treated with traditional vitrectomy were served as control. The operations were finished successfully in both different vitrectomy systems, but fundus cannot be visualized during fluid-gas exchange in phakic eyes, and intraocular illumination had to been used again in OFFISS group. Postoperatively, retina was fully attached in all eyes, best-corrected visual acuity of 19 eyes had improved two lines and more in OFFISS group, and 17 eyes in control group. No significant difference in surgical complications was found between OFFISS and traditional vitrectomy group. Mean duration of peeling membrane was less in OFFISS group than control group. The efficacy of vitrectomy using different system for severe PDR both are satisfactory and comparable. We consider vitrectomy using OFFISS more safe and effective during complicated surgical manipulations than using traditional vitrectomy system.