Trimanual vitrectomy versus bimanual vitrectomy in tractional proliferative diabetic retinopathy

Abstract

Objective To evaluate the impact as well as safety of trimanual vitrectomy versus bimanual vitrectomy in cases with complicated proliferative diabetic retinopathy (PDR) necessitating surgical intervention.Methods We designed a randomized, interventional, prospective study on 40 pseudophakic eyes suffering from tractional retinal detachment (TRD). 20 eyes of 16 cases with trimanual 23-gauge Parsplana vitrectomy (PPV) were categorized as Group A ”trimanual group.” Twenty eyes of 18 cases with bimanual 23-gauge PPV were categorized as Group B” bimanual group” in the duration between May 2021 and December 2022. All cases were under continual observation for ≥ 6 months postoperatively.Results A total of 40 eyes out of 34 cases with the mean age of cases 50.5 years (ranged between 29–69 y) in group A and 47.9 (ranged between 33–60 y) old in group B were assessed. Retinal attachment, total elimination of the pre-retinal proliferation attained in all cases of the two groups. Surgical time was statistically significant shorter in the trimanual group compared to bimanual group (p value < 0.05). Both groups gained statistically significant better vision. The mean pre-operative VA (Visual acuity) in group A was 1.75 (Log MAR) and 1.59 in group B, whereas the mean final visual outcome 6 months following operation was 0.73 in the 1st group & 0.82 in the 2nd one (p value < 0.001*).Conclusion Trimanual PPV is a safe as well as efficient approach that may ameliorate the result of vitrectomy in tractional PDR.

Keywords

• Tractional retinal detachment
• perfluorocarbon liquids
• vital dyes
• pars plana vitrectomy