The treatment of advanced diabetic eye disease

Summary

Pars plana vitrectomy can be successfully used to treat complications resulting from proliferative diabetic retinopathy including nonabsorbing vitreous haemorrhage, recent traction or rhegmatogenous retinal detachment, and progressive fibrovascular proliferation. Vitreous surgery can be expected to result in improved vision in approximately 60–70% of these cases and approximately 50% of patients achieve navigational vision or better. If all the posterior cortical vitreous is removed no preretinal fibrovascular growth occurs after surgery. On the other hand, if nonatrophic, epiretinal fibrovascular membranes are not removed, they often undergo contraction after surgery and may detach or distort the adjacent retina. Pars plana vitrectomy is a complex surgical procedure with a significant complication rate, but it does offer a chance of vision in eyes that were hitherto considered untreatable and thus irrevocably blind.