In the Journals

Small-gauge PPV can be used for non-clearing diabetic vitreous hemorrhage

Postoperative vitreous hemorrhage occurred in about one-third of eyes that underwent initial 23-gauge pars plana vitrectomy for diabetic vitreous hemorrhage, according to a study.

The retrospective case series included 173 eyes of 157 patients who underwent 23-gauge pars plana vitrectomy (PPV) for non-clearing diabetic vitreous hemorrhage stemming from proliferative diabetic retinopathy. Minimum postoperative follow-up was 6 weeks; mean follow-up was 32 weeks.

Patients were expected to have undergone some scatter photocoagulation at least 6 weeks before primary surgery.

Fifty-six eyes (32%) developed postoperative vitreous hemorrhage rated as early in eight eyes, delayed in 13 eyes and severe persistent in 35 eyes.

Twenty-two eyes required revision PPV; the mean interval between initial surgery and revision was 15 weeks. Postoperative vitreous hemorrhage appeared in one eye that underwent revision PPV. Thirty-four patients had adequate spontaneous resolution of vitreous hemorrhage and did not require re-treatment.

Thirty-four of 127 eyes (27%) with complete scatter photocoagulation and 22 of 46 eyes (48%) with incomplete scatter photocoagulation developed postoperative vitreous hemorrhage; the between-group difference was statistically significant (P = .002).

Younger age and phakic status were also associated with postoperative vitreous hemorrhage (P = .022 and P = .036, respectively).

Mean logMAR visual acuity improved significantly, from 1.5 preoperatively to 0.65 postoperatively (P < .0001), the authors said.

Postoperative vitreous hemorrhage occurred in about one-third of eyes that underwent initial 23-gauge pars plana vitrectomy for diabetic vitreous hemorrhage, according to a study.

The retrospective case series included 173 eyes of 157 patients who underwent 23-gauge pars plana vitrectomy (PPV) for non-clearing diabetic vitreous hemorrhage stemming from proliferative diabetic retinopathy. Minimum postoperative follow-up was 6 weeks; mean follow-up was 32 weeks.

Patients were expected to have undergone some scatter photocoagulation at least 6 weeks before primary surgery.

Fifty-six eyes (32%) developed postoperative vitreous hemorrhage rated as early in eight eyes, delayed in 13 eyes and severe persistent in 35 eyes.

Twenty-two eyes required revision PPV; the mean interval between initial surgery and revision was 15 weeks. Postoperative vitreous hemorrhage appeared in one eye that underwent revision PPV. Thirty-four patients had adequate spontaneous resolution of vitreous hemorrhage and did not require re-treatment.

Thirty-four of 127 eyes (27%) with complete scatter photocoagulation and 22 of 46 eyes (48%) with incomplete scatter photocoagulation developed postoperative vitreous hemorrhage; the between-group difference was statistically significant (P = .002).

Younger age and phakic status were also associated with postoperative vitreous hemorrhage (P = .022 and P = .036, respectively).

Mean logMAR visual acuity improved significantly, from 1.5 preoperatively to 0.65 postoperatively (P < .0001), the authors said.