Diabetic vitrectomy: influence of lens status upon anatomic and visual outcomes.
OBJECTIVE
To determine the effect of lens status upon the anatomic and visual results in primary diabetic vitrectomy.


METHODS
Retrospective, comparative, consecutive case series.


METHODS
One hundred two eyes of 85 patients with proliferative diabetic retinopathy and its complications that underwent primary vitrectomy.


METHODS
The eyes that remained phakic after vitrectomy were compared with the eyes that were either aphakic or pseudophakic (nonphakic) postoperatively.


METHODS
Intraoperative and postoperative complications, vitreoretinal reoperation rate, and ultimate anatomic and visual success with at least 6 months' follow-up.


RESULTS
Preoperatively, 72 eyes were phakic, and 30 were aphakic (n = 1) or pseudophakic (n = 29). During vitrectomy, 1 eye underwent lensectomy and 12 eyes underwent phacoemulsification with lens implantation. Postoperatively, 59 eyes were phakic and 43 eyes were nonphakic. The vitreoretinal reoperation rate was significantly higher (P = 0.04) for the phakic group (28.8%) than for the nonphakic group (11.6%). Rubeosis iridis developed in 3 phakic eyes and no nonphakic eyes (P = 0.26). Intraoperative complications were similar in the phakic and nonphakic groups (P = 0.40). Postoperative complications such as rhegmatogenous retinal detachment (P = 0.39), nonclearing vitreous hemorrhage (P = 0.07), and anterior chamber complications (P = 0.60) were also similar. Visual acuity improved by at least 0.2 logarithm of the minimum angle of resolution units in 76.2% of the phakic eyes and 86.0% of the nonphakic eyes (P = 0.22).


CONCLUSIONS
Eyes that were phakic after primary diabetic vitrectomy had a significantly higher subsequent vitreoretinal reoperation rate when compared with nonphakic eyes, suggesting that diabetic eyes are less likely to require additional vitreoretinal surgery if they are rendered nonphakic before or during vitrectomy.
Schiff
William M
WM
Department of Ophthalmology, Columbia University College of Physicians and Surgeons, Edward S. Harkness Eye Institute and St. Luke's-Roosevelt Hospital Center, New York, New York, USA. wms13@columbia.edu
Barile
Gaetano R
GR
Hwang
John C
JC
Tseng
Joseph J
JJ
Cekiç
Osman
O
Del Priore
Lucian V
LV
Chang
Stanley
S
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001035:Aphakia / Q000150:complications; D003930:Diabetic Retinopathy / Q000150:complications / Q000503:physiopathology* / Q000601:surgery*; D005260:Female; D006801:Humans; D007908:Lens, Crystalline / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011184:Postoperative Period; D019591:Pseudophakia / Q000150:complications; D012086:Reoperation / Q000706:statistics & numerical data; D012160:Retina / Q000601:surgery; D012189:Retrospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity; D014821:Vitrectomy; D014822:Vitreous Body / Q000601:surgery