Entry site treatment to prevent late recurrent postoperative vitreous cavity haemorrhage after vitrectomy for proliferative diabetic retinopathy.

AIMS

To assess the effectiveness of treatment to the inner sclerostomy sites at the time of vitrectomy for proliferative diabetic retinopathy (PDR) in reducing the incidence of late recurrent postoperative vitreous cavity haemorrhage (POVCH).

METHOD

Retrospective study of a consecutive series of 82 eyes undergoing vitrectomy for PDR by a single surgeon treated with either cryotherapy or argon laser directly to the inner sclerostomy site at the completion of surgery (treatment group). These were compared with a previous consecutive series of 82 eyes operated on by the same surgeon who did not have inner sclerostomy site treatment (control group). The occurrence of any POVCH was recorded within the first 6 months of surgery.

RESULTS

The composition of the two groups was similar in terms of age, indication for surgery and a variety of other preoperative factors. There were 64 patients in the control group and 65 in the treatment group. There was a significant reduction in the incidence of late recurrent POVCH in the treatment group. Late recurrent POVCH occurred in 12 (15%) eyes in the control group compared with five (6%) in the treatment group (p=0.03). The number of eyes requiring revision surgery within the first 6 months for late recurrent POVCH was four (5%) in the control group and two (2.5%) in the treatment group (p=0.31).

CONCLUSION

This study suggests that inner sclerostomy site treatment is effective in reducing the occurrence of recurrent late POVCH in patients undergoing vitrectomy for PDR. A randomised controlled study is needed to clarify this.