Supplemental Dextrose in the Infusion Fluid during Diabetic Vitrectomy

Abstract

Historically, supplemental dextrose to infusion fluid has been used to reduce the need for intraoperative lensectomies to maintain visualization during diabetic vitrectomy. Valved, small-gauge vitrectomy has reduced surgical time and decreased intraoperative fluid flow. Assessment of supplemental dextrose in modern vitrectomy is presented here. Retrospective cohort study of diabetic patients undergoing vitrectomy. The dextrose group received supplemental dextrose in the infusion fluid, while the nondextrose group used standard balanced salt solution (BSS Plus). Group assignment was per surgeons’ typical practice patterns. Eyes with tractional retinal detachments were also evaluated as a subgroup. 330 phakic eyes were included. Supplemental dextrose was used in 199 eyes (60.3%). One unplanned lensectomy was performed in this series, in the nondextrose group, not statistically different from the dextrose group, with zero lensectomies (p = 0.4). Cataract survival curves overlapped for all eyes and for the tractional retinal detachment subgroup. In modern vitrectomy, unplanned lensectomy is rare. No difference was observed in the rate of intraoperative lensectomies or overall postoperative cataract course with or without dextrose supplementation to the infusion fluid. Standard solutions appear to be adequate for infusion, even for diabetics.