International Journal of Biomedicine (Mar 2013)
Proliferative Diabetic Retinopathy Surgery against the Background of Prior Retinal Laser Coagulation
Abstract
The study has been performed to compare the immediate and long-term outcomes of Vitreoretinal Surgery (VS) on patients with Proliferative Diabetic Retinopathy (PDR) in relation to Prior Retinal Laser Coagulation (PLC). The study included 56 patients (71 eyes) with diabetes mellitus (type 2 - 52/93%, men – 39/75%) complicated with proliferative diabetic retinopathy (PDR), requiring VS. Of these, 33 eyes (no PLC) underwent primary vitrectomy, while the remaining 38 eyes (PLC) had undergone panretinal laser coagulation over the past five years. In our study, PLC significantly contributed to the preservation of improved functional retinal status, despite the development of complications, which is an indication for VS. The PLC patients exhibited early recovery and a higher visual acuity throughout the observation period. Thus, the study revealed that in the case of prior VS, laser photocoagulation of the retina helps preserve the visual acuity, both at the time of and during the first year after surgery, reduces surgery duration and decreases the need to tamponade the vitreous cavity with silicone oil. Besides, PLC of the retina is accompanied by a significantly lower incidence of intra- and post-operational hemorrhage and reduces the need for repeated vitreoretinal procedures. The present study presents further arguments in favor of early retinal laser photocoagulation on patients with diabetes mellitus complicated by PDR.