Frequency of epithelial debridement during diabetic vitrectomy.
OBJECTIVE
To survey active vitreoretinal surgeons to determine how often they intentionally debride the corneal epithelium during vitrectomy surgery for diabetic patients and to ascertain whether the selection of the surgical lens type influences the debridement rate.


METHODS
Observational retrospective case series.


METHODS
Fifty-five vitreoretinal surgeons were asked to retrospectively report how many pars plana vitrectomies they performed in 1 year on diabetic eyes and in what percent of the cases was debridement of the cornea necessary. In a second query, they were asked to note which specific type of surgical lens system (hand-held irrigating, Landers sew-on, or Oculus BIOM noncontact) was used for their surgical intervention.


RESULTS
The total number of diabetic vitrectomies performed in 1 year by the respondents was 8,002. The frequency of epithelial debridement was 17.4%, with a range of 0% to 90%. The use of irrigating contact lenses was associated with a significantly higher rate of debridement compared with the use of sew-on or BIOM noncontact lenses (23.5% vs 12.1%, P <.001). Regarding the 41 surgeons who indicated a specific type of lens used, we found that the debridement rate for infusion lenses was 23.8% compared with 13.0% for sew-on lenses and 15.6% for noncontact BIOM lenses. The difference between these groups was statistically significant (P <.025).


CONCLUSIONS
Irrigating contact lenses appear to increase the need for epithelial debridement compared with other alternatives. Sew-on lenses with a viscoelastic cushion may provide the best corneal protection.
Friberg
Thomas R
TR
Eye & Ear Institute, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania 15213, USA. Friberg@pitt.edu
Ohji
Masahito
M
Scherer
Joseph J
JJ
Tano
Yasuo
Y
D003646:Debridement / Q000706:statistics & numerical data*; D003930:Diabetic Retinopathy / Q000601:surgery*; D004847:Epithelial Cells; D019573:Epithelium, Corneal / Q000166:cytology / Q000601:surgery*; D006801:Humans; D009885:Ophthalmology; D010818:Practice Patterns, Physicians'; D012189:Retrospective Studies; D014821:Vitrectomy / Q000295:instrumentation / Q000706:statistics & numerical data*