The outcomes and prognostic factors of vitrectomy in chronic diabetic traction macular detachment.
OBJECTIVE
To investigate the outcomes of pars plana vitrectomy (PPV) for chronic diabetic traction macular detachment (CTMD).


METHODS
Ninety-six eyes that underwent PPV for CTMD of at least 6 months duration were retrospectively analyzed. Retinal reattachment rate, final vision, and prognostic factors for poor visual outcome were the main outcome measures.


RESULTS
All eyes had long-standing TMD (median 12, range: 6-70 months). The median postoperative follow-up was 15 (range: 3-65) months. Eighty-seven eyes (90.6%) had their retina and macula reattached after one PPV. At final examination, 84 eyes (87.5%) had stable vision or at least one line improvement, and three had no light perception. Seventeen (17.7%) and 41 (43%) eyes had preoperative visual acuity of ≥20/200 and ≥5/200 as compared to 40 (41.6%; P=0.0005) and 64 (66.7%; P=0.0014) eyes at final follow-up, respectively. Age >50 years (Odds ratio [OR] =5.84, 95% confidence interval [CI] =1.53-22.19, P=0.01), preoperative vision <20/400 (OR =7.012, 95% CI =1.82-26.93, P=0.005), and ischemic macula (OR =14.13, 95% CI =3.61-55.33, P<0.001) were significantly associated with final vision <20/400.


CONCLUSIONS
PPV for CTMD may be beneficial particularly in patients who are relatively younger and have good baseline vision and no macular ischemia.
Vitreoretinal Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia.
Muneera A
MA
Abunajma
Vitreoretinal Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia.
Hassan
H
Al-Dhibi
Vitreoretinal Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia.
Emad B
EB
Abboud
Vitreoretinal Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia.
Yahya
Y
Al Zahrani
Al Hokama Eye Center, Riyadh, Saudi Arabia.
Essam
E
Alharthi
Department of Ophthalmology, College of Medicine, King Saud University Riyadh, Saudi Arabia.
Abdullah
A
Alkharashi
Vitreoretinal Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia; Department of Ophthalmology, University of Virginia, Charlottesville, VA, USA.
Nicola G
NG
Ghazi
chronic diabetic traction macular detachment; diabetic retinopathy; diabetic traction macular detachment; pars plana vitrectomy