Outcomes of vitrectomy for diabetic tractional retinal detachment in Chicago's county health system.

PURPOSE: To examine outcomes of 23-gauge (23G) pars plana vitrectomy (PPV) for complex diabetic tractional retinal detachment (TRD) in Chicago's Cook County Health and Hospitals System (CCHHS). MATERIALS AND METHODS: This is a retrospective noncomparative study of diabetic TRD cases that underwent PPV at CCHHS. Primary retinal reattachment rate, visual function, and postoperative complications were analyzed. RESULTS: Sixty nine consecutive cases were included. Primary reattachment and final attachment were achieved in 68/69 eyes (98.6%). Secondary retinal detachment was noted in 1 eye (1.4%). Vitreous hemorrhage requiring repeat PPV developed in 5 eyes (7.2%) and reoperation due to other complications was required in 4/69 eyes (5.8%). Perfluoropropane (C3F8) gas tamponade was used in 91.3% of eyes and silicone oil in 8.7% of eyes. Mean LogMAR visual acuity significantly improved from 1.84 ± 0.61 to 0.93 ± 0.66, (P<0.0001). Vision was stabilized or improved in 66 eyes (95.7%). Visual acuity of 20/200 or better was achieved in 49/69 eyes (71.0%) and 20/50 or better in 16/69 eyes (23.2%). CONCLUSIONS: Even in patients with severe and advanced diabetic TRD pathology and unique demographics as seen in CCHHS, modern vitrectomy techniques can provide excellent anatomical and visual outcomes.

PARS PLANA VITRECTOMY COMBINED WITH CATARACT EXTRACTION: A Comparison of Surgical Outcomes Using Single-Piece and Multipiece Foldable Intraocular Lenses.

PURPOSE: To assess whether complication rates are comparable between phacovitrectomy using multipiece lenses versus single-piece foldable intraocular lenses. METHODS: Single-center, multisurgeon retrospective comparative consecutive interventional case series. Two hundred and seventy-one patients undergoing combined phacovitrectomy performed during a single session at a university-based ophthalmology practice from 2004 to 2013 were identified, of whom 184 met study inclusion criteria; 56.4% patients had diabetes mellitus. RESULTS: There was no difference in the total incidences of postoperative complications between combined surgery using single-piece and multipiece intraocular lenses (P = 0.80) or among individual complications between the 2 groups, including synechiae (2.7 vs. 5.3%; P = 0.61), pupillary capture (0.7 and 2.6%; P = 0.36), and lens subluxation (1.4 and 0%; P > 0.99). There was no difference in the incidences of complications in patients with diabetes mellitus compared with nondiabetic patients undergoing phacovitrectomy (P = 0.13). Complication rates did not differ between single-piece and multipiece lenses with the use of postoperative intravitreal tamponade (P = 0.67). CONCLUSION: Single-piece, acrylic intraocular lenses are associated with a low rate of surgical complications after combined phacovitrectomy and represent an acceptable alternative to multipiece foldable intraocular lenses under the circumstances and using the surgical techniques implemented in this study.