Long-term results of the use of viscodissection with contrast in surgery for proliferative diabetic retinopathy

Abstract

Purpose. To evaluate long-term results of surgery for proliferative diabetic retinopathy using contrast-enhanced viscodissection. Material and methods.The study involved 30 patients with type 1 diabetes mellitus (DM) and PDR with traction retinal detachment (TRD). All patients were divided into two groups. In the main group, viscodissection with contrast was performed; in the control group, segmentation and membrane removal were performed using a vitreotome and endovitreal forceps. The observation period was 12 months. Results. During dynamic observation, all patients showed a positive dynamics of morphofunctional parameters. In patients of the control group, in the vast majority of cases, it was necessary to resort to tamponade with silicone oil (60%) or gasair mixture (33%), while in the main group, the main postoperative media were sterile BSS solution (73%) and gas-air mixture (27%). 60% of patients in the control group required a reoperation to remove silicone oil. In patients of the control group in the late postoperative period, IOP values were significantly higher (main group 14.3 ± 1.1; control group 18.7 ± 1.5; p < 0.05), and late postoperative vitreous hemorrhage developed more often (2.3 ± 0.5 in the main group, 4.1 ± 0.6 in the control group; p < 0.05). Conclusion. In the long-term follow-up, the use of this method reduces the need for repeated endovitreal intervention, reduces the risk of developing late postoperative vitreous hemorrhage, and has a positive effect on IOP by reducing the need for endotamponade with silicone oil. Keywords: diabetes mellitus, proliferative diabetic retinopathy, vitreoretinal surgery, contrastenhanced viscodissection