Wound sealing-related complications of 25-gauge vitrectomy in proliferative diabetic retinopathy versus simple macular pathology

Purpose : To compare the incidence of wound sealing-related complications of
25-gauge transconjunctival sutureless vitrectomy (25-G TSV) for proliferative diabetic retinopathy
(PDR) versus non-diabetic simple macular pathology (SMP). Methods : A retrospective
comparative study was conducted on 377 eyes that underwent 25-G TSV for PDR
(n=189 eyes) or non-diabetic SMP (n=188 eyes). Both groups were compared retrospectively
and followed for at least 1 month (range 1-6 months). Main outcome measure was
the incidence of postoperative wound sealing-related complications in both groups. Results
: We found a statistically significant lower incidence of wound sealing-related complications
on the 1st postoperative day in the PDR than SMP group (P-value 0.05). The
incidence were as follows : 9% vs 18% for hypotony, 0% vs 2% for choroidal detachment,
0% vs 2% for external leakage and 1% vs 8% for conjunctival bleb formation, for the PDR
and SMP groups respectively. This was associated with a significantly higher postoperative
inflammation and IOP in PDR group. The day 1 higher postoperative IOP and inflammation
were correlated with the presence of PDR pathology. Conclusion : The higher postoperative
inflammation and IOP following vitrectomy in diabetic eyes, especially when
combined with endolaser photocoagulation, makes such eyes less susceptible to wound
sealing-related complications following sutureless vitrectomy.

The journal of medical investigation : http://medical.med.tokushima-u.ac.jp/jmi/index.html