Repair of Tractional Retinal Detachment

Abstract

Thorough preoperative evaluation should be performed including extent of ischemia and neovascularization on fluorescein angiography and delineation of potential surgical planes and fovea status on optical coherence tomography. The patient should then undergo a thorough informed consent process including the need for an expedient repair and the risks involved with vitrectomy-based surgery. Preoperative considerations include staged phacoemulsification surgery, systemic optimization, preoperative panretinal photocoagulation (weeks preoperatively), and/or intravitreal anti-VEGF (1–3 days preoperatively) therapy. There is great heterogeneity in the management of diabetic tractional retinal detachments, and this segment delineates our typical practice pattern and thus is certainly not the only method for tackling these challenging cases.