Total en bloc excision: a modified vitrectomy technique for proliferative diabetic retinopathy.
OBJECTIVE
To report a modified vitrectomy technique for proliferative diabetic retinopathy.


METHODS
Interventional case series.


METHODS
In the modified vitrectomy technique for proliferative diabetic retinopathy, core vitrectomy is performed, followed by separation of the glial ring from the optic disk using a hook or forceps. The posterior hyaloid membrane, including proliferative tissues, is lifted and peeled from the posterior to the peripheral retina without creating a window in the posterior hyaloid membrane. At any strong vitreoretinal adhesion site, the posterior hyaloid is partially removed, followed by membrane delamination.


RESULTS
In the 18 eyes that underwent the modified technique, iatrogenic retinal breaks occurred less often compared with the 48 eyes that underwent the conventional technique. The difference was not statistically significant (P =.14), but the surgical time was significantly reduced (P =.0003). The glial ring and proliferative tissue arising from the optic disk can be readily separated, and other adhesion sites can be satisfactorily peeled after separating the posterior hyaloid membrane around the optic disk.


CONCLUSIONS
This modified vitrectomy technique for proliferative diabetic retinopathy may be an alternative surgical technique to the conventional technique.
Kakehashi
Akihiro
A
Department of Ophthalmology, Omiya Medical Center, Jichi Medical School, Saitama, Japan. kakeaki@omiya.jichi.ac.jp
D003930:Diabetic Retinopathy / Q000601:surgery*; D006801:Humans; D007049:Iatrogenic Disease / Q000517:prevention & control; D012167:Retinal Perforations / Q000517:prevention & control; D013997:Time Factors; D014821:Vitrectomy / Q000379:methods*