title: Long-term outcomes of sutureless 25-G+ pars-plana vitrectomy for the management of diabetic tractional retinal detachment.
abstract: OBJECTIVE
  To evaluate the short- and long-term surgical and clinical outcomes in eyes with diabetic tractional retinal detachment (TRD) undergoing 25-G+ pars-plana vitrectomy (PPV).
  
  
  METHODS
  A total of 238 patients were reviewed for inclusion in this study. A retrospective cohort study of 109 eyes of 73 patients operated on for diabetic TRD were included. All eyes received intraocular tamponade of air, sulfur hexafluoride, octofluropropane or silicone oil. All patients were followed up for a minimum period of one year.
  
  
  RESULTS
  The mean age of all patients at surgery was 53.9 years ± 9.2, while the mean duration of diabetes was 18.7 ± 10.4 years. The mean length of follow-up was 923 ± 87 days after surgery (range, 432-1792 days). Thirty-two cases (29.3 %) had an associated rhegmatogenous component. Mean BCVA improved from logarithm minimum angle of resolution (logMAR) 1.17 (20/300) to 0.812 (20/130) (p < 0.05). All eyes underwent intraoperative laser photocoagulation. Primary, single-surgery anatomic reattachment was achieved in 99 eyes (91 %). Final anatomic attachment was achieved in 107 eyes (98 %). There was no statistically significant difference in primary or secondary re-attachment rate in terms of type of tamponade agent used. There were five cases of post-operative hypotony (≤5 mmHg) on postoperative day 1, while 11 eyes had IOP ≥ 30 mmHg. There were no cases of endophthalmitis in our cohort.
  
  
  CONCLUSIONS
  25G+ PPV provides for safe and effective repair of diabetic TRDs. Patients experienced positive functional and anatomic outcomes, with no significant intraoperative complications and minimal postoperative sequelae.
authors.affiliation: Department of Ophthalmology, Jewish General Hospital, McGill University, 3755 Côte-Ste-Catherine Road, Montreal, Québec, H3T1E2, Canada. mikel.mikhail@mail.mcgill.ca.
authors.forename: Mikel
authors.initials: M
authors.lastname: Mikhail
authors.affiliation: Department of Ophthalmology, Jewish General Hospital, McGill University, 3755 Côte-Ste-Catherine Road, Montreal, Québec, H3T1E2, Canada.
authors.forename: Andre
authors.initials: A
authors.lastname: Ali-Ridha
authors.affiliation: Department of Ophthalmology, Université de Montréal, Montreal, QC, Canada.
authors.forename: Sarah
authors.initials: S
authors.lastname: Chorfi
authors.affiliation: Department of Ophthalmology, Jewish General Hospital, McGill University, 3755 Côte-Ste-Catherine Road, Montreal, Québec, H3T1E2, Canada.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Kapusta
mesh_terms: D003930:Diabetic Retinopathy / Q000150:complications / Q000601:surgery*; D058450:Endotamponade / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D011792:Quebec / Q000453:epidemiology; D012163:Retinal Detachment / Q000209:etiology / Q000601:surgery*; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D014792:Visual Acuity; D014821:Vitrectomy / Q000379:methods*
keywords: 25-gauge; Diabetes; Proliferative diabetic retinopathy; Tamponade; Tractional retinal detachment; Vitrectomy