title: Advantages of diabetic tractional retinal detachment repair.
abstract: OBJECTIVE
  To evaluate the outcomes and complications of patients with diabetic tractional retinal detachment (TRD) treated with pars plana vitrectomy (PPV).
  
  
  METHODS
  We retrospectively studied a case series of 24 eyes of 21 patients at a single tertiary, university-affiliated medical center. A review was carried out on patients who underwent PPV for the management of TRD due to proliferative diabetic retinopathy from October 2011 to November 2013. Preoperative and final visual outcomes, intraoperative and postoperative complications, and medical background were evaluated.
  
  
  RESULTS
  A 23 G instrumentation was used in 23 eyes (95.8%), and a 25 G instrumentation in one (4.2%). Mean postoperative follow-up time was 13.3 months (4-30 months). Visual acuity significantly improved from logarithm of the minimum angle of resolution (LogMAR) 1.48 to LogMAR 1.05 (P<0.05). Visual acuity improved by ≥3 lines in 75% of patients. Intraoperative complications included iatrogenic retinal breaks in seven eyes (22.9%) and vitreal hemorrhage in nine eyes (37.5%). In two eyes, one sclerotomy was enlarged to 20 G (8.3%). Postoperative complications included reoperation in five eyes (20.8%) due to persistent subretinal fluid (n=3), vitreous hemorrhage (n=1), and dislocated intraocular lens (n=1). Thirteen patients (54.2%) had postoperative vitreous hemorrhage that cleared spontaneously, five patients (20.8%) required antiglaucoma medications for increased intraocular pressure, seven patients (29.2%) developed an epiretinal membrane, and two patients (8.3%) developed a macular hole.
  
  
  CONCLUSIONS
  Patients with diabetic TRD can benefit from PPV surgery. Intraoperative and postoperative complications can be attributed to the complexity of this disease.
authors.affiliation: Department of Ophthalmology, Rabin Medical Center, Beilinson Campus, Petach Tikva, Israel.
authors.forename: Amir
authors.initials: A
authors.lastname: Sternfeld
authors.affiliation: Department of Ophthalmology, Rabin Medical Center, Beilinson Campus, Petach Tikva, Israel.
authors.forename: Ruth
authors.initials: R
authors.lastname: Axer-Siegel
authors.affiliation: Department of Ophthalmology, Rabin Medical Center, Beilinson Campus, Petach Tikva, Israel.
authors.forename: Hadas
authors.initials: H
authors.lastname: Stiebel-Kalish
authors.affiliation: Department of Ophthalmology, Rabin Medical Center, Beilinson Campus, Petach Tikva, Israel.
authors.forename: Dov
authors.initials: D
authors.lastname: Weinberger
authors.affiliation: Department of Ophthalmology, Rabin Medical Center, Beilinson Campus, Petach Tikva, Israel.
authors.forename: Rita
authors.initials: R
authors.lastname: Ehrlich
keywords: diabetic retinopathy; proliferative vitreoretinopathy; retinal detachment; vitrectomy; vitreoretinal surgery