Korean J Ophthalmol.  2017 Jun;31(3):217-229. 10.3341/kjo.2016.0018.

Predictors and Outcomes of Vitrectomy and Silicone Oil Injection in Advanced Diabetic Retinopathy

• Ramezani A
• Ahmadieh H
• Rozegar A
• Soheilian
• Entezari M
• Moradian S
• Dehghan MH
• Nikkhah H
• Yaseri M

• KMID: 2379878
• DOI: http://doi.org/10.3341/kjo.2016.0018

Abstract

PURPOSE
To evaluate visual and anatomical results and identify factors that influence vitrectomy and silicone oil (SO) injection outcomes in proliferative diabetic retinopathy (PDR).
METHODS
This retrospective study included 236 eyes with PDR that were undergoing vitrectomy and SO injection with >3-month follow-up. The primary outcomes were final best-corrected visual acuity (BCVA) and retinal attachment rate.
RESULTS
At the final visit (mean, 88 ± 58 weeks), complete, partial, and no retinal attachment were observed in 86.9%, 10.6%, and 2.5% of patients, respectively. A total of 155 eyes had experienced SO removal, while 81 had SO in place. The mean initial BCVA was 1.9 ± 0.7 logarithm of the minimum angle of resolution (logMAR) and significantly improved to 1.7 ± 0.8 logMAR (p = 0.001). Initial macular detachment (adjusted odds ratio [AOR], 0.25), development of iatrogenic break (AOR, 0.25), and use of heavy SO (AOR, 0.13) were independently associated with a lower risk of final retinal attachment, and SO removal was associated with a higher incidence (AOR, 7.55). Better baseline BCVA was associated with a higher risk of final BCVA ≥20 / 200.
CONCLUSIONS
Despite an encouraging outcome based on anatomical data in advanced PDR treated with vitrectomy and SO, the functional prognosis was not satisfying for patients. Eyes with better vision at baseline had a more favorable prognosis, whereas eyes with initial macular detachment, intraoperative iatrogenic break, or heavy SO showed more unfavorable outcomes. In selected cases, extending the time of SO use did not worsen the prognosis.

Keyword

Diabetic retinopathy; Outcome; Silicone oils; Vitrectomy

MeSH Terms

Diabetic Retinopathy*
Follow-Up Studies
Humans
Incidence
Odds Ratio
Prognosis
Retinaldehyde
Retrospective Studies
Silicon*
Silicone Oils
Silicones*
Visual Acuity
Vitrectomy*
Retinaldehyde
Silicon
Silicone Oils
Silicones

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