Diabetic vitrectomy: the influence of lens status upon surgical outcomes.
OBJECTIVE
Management of the lens in diabetic eyes undergoing vitrectomy has long been a source of controversy. Initially, the lens was removed during diabetic vitrectomy because of intraoperative changes. It was noted, however, that anterior segment neovascular complications were greater in aphakic eyes after diabetic vitrectomy, and subsequently the vitreoretinal surgeon attempted to spare the lens. Lens management in this regard continues to attract discussion. This report reviews recent trends in the management of the native lens in the diabetic eye undergoing vitrectomy.


RESULTS
The rate of cataract formation after diabetic vitrectomy is high in eyes left phakic. The rates of anterior segment neovascularization and retinal detachment after diabetic vitrectomy are similar in phakic and nonphakic eyes. The rate of subsequent reoperation after diabetic vitrectomy may be greater in eyes left phakic.


CONCLUSIONS
Although the management of the lens in an eye undergoing diabetic vitrectomy should be individualized, cataract extraction performed either before or in combination with vitrectomy may reduce the rate of subsequent reoperation. The vitreoretinal surgeon may consider rendering an eye nonphakic before or during diabetic vitrectomy to optimize outcomes.
Bhatnagar
Pawan
P
Department of Ophthalmology, Columbia University College of Physicians and Surgeons, Edward S. Harkness Eye Institute and St. Lukes-Roosevelt Hospital Center, New York, New York, USA.
Schiff
William M
WM
Barile
Gaetano R
GR
D002386:Cataract / Q000175:diagnosis / Q000209:etiology*; D002387:Cataract Extraction; D003930:Diabetic Retinopathy / Q000150:complications / Q000175:diagnosis / Q000601:surgery; D006801:Humans; D007908:Lens, Crystalline / Q000473:pathology*; D011379:Prognosis; D012307:Risk Factors; D014821:Vitrectomy / Q000379:methods*