Department of Ophthalmology and Visual Science, University of Chicago, Chicago, Illinois, United States of America.
Department of Ophthalmology, Chicago Cook County Hospitals and Health System (CCHHS), Chicago, Illinois, United States of America.
PLoS One. 2019 Aug 20;14(8):e0220726. doi: 10.1371/journal.pone.0220726. eCollection 2019.
To examine outcomes of 23-gauge (23G) pars plana vitrectomy (PPV) for complex diabetic tractional retinal detachment (TRD) in Chicago's Cook County Health and Hospitals System (CCHHS).
This is a retrospective noncomparative study of diabetic TRD cases that underwent PPV at CCHHS. Primary retinal reattachment rate, visual function, and postoperative complications were analyzed.
Sixty nine consecutive cases were included. Primary reattachment and final attachment were achieved in 68/69 eyes (98.6%). Secondary retinal detachment was noted in 1 eye (1.4%). Vitreous hemorrhage requiring repeat PPV developed in 5 eyes (7.2%) and reoperation due to other complications was required in 4/69 eyes (5.8%). Perfluoropropane (C3F8) gas tamponade was used in 91.3% of eyes and silicone oil in 8.7% of eyes. Mean LogMAR visual acuity significantly improved from 1.84 ± 0.61 to 0.93 ± 0.66, (P<0.0001). Vision was stabilized or improved in 66 eyes (95.7%). Visual acuity of 20/200 or better was achieved in 49/69 eyes (71.0%) and 20/50 or better in 16/69 eyes (23.2%).
Even in patients with severe and advanced diabetic TRD pathology and unique demographics as seen in CCHHS, modern vitrectomy techniques can provide excellent anatomical and visual outcomes.
研究芝加哥库克县健康与医院系统（CCHHS）中 23G 经平坦部玻璃体切除术（PPV）治疗复杂糖尿病牵引性视网膜脱离（TRD）的结果。
这是一项回顾性非对照研究，纳入了在 CCHHS 接受 PPV 的糖尿病 TRD 病例。分析了主要视网膜复位率、视力功能和术后并发症。
共纳入 69 例连续病例。69 只眼中有 68 只（98.6%）达到了初次和最终复位。1 只眼（1.4%）出现继发性视网膜脱离。5 只眼（7.2%）需要再次行 PPV 以治疗玻璃体积血，4/69 只眼（5.8%）因其他并发症需要再次手术。91.3%的眼使用全氟丙烷（C3F8）气体填充，8.7%的眼使用硅油填充。平均 LogMAR 视力显著从 1.84 ± 0.61 提高到 0.93 ± 0.66（P<0.0001）。66 只眼（95.7%）视力稳定或改善。69 只眼中有 49 只（71.0%）视力达到 20/200 或更好，16 只（23.2%）视力达到 20/50 或更好。
即使在 CCHHS 中所见的具有严重和晚期糖尿病 TRD 病理且具有独特人口统计学特征的患者中，现代玻璃体切除术技术也能提供出色的解剖学和视力结果。
