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Entry site treatment to prevent late recurrent postoperative vitreous cavity haemorrhage after vitrectomy for proliferative diabetic retinopathy
  1. David H W Steel*,
  2. Alan John Connor,
  3. Maged S Habib,
  4. Rona I Owen
  1. 1 Sunderland Eye Infirmary, United Kingdom
  1. Correspondence to: David Steel, Sunderland Eye Infirmary, Sunderland Eye Infirmary, Sunderland, SR2 9HP, United Kingdom; dhwsteel{at}hotmail.com

Abstract

Aims: To assess the effectiveness of treatment to the inner sclerostomy sites at the time of vitrectomy for proliferative diabetic retinopathy (PDR) in reducing the incidence of late recurrent post operative vitreous cavity haemorrhage (POVCH) .

Method: Retrospective study of a consecutive series of 82 eyes undergoing vitrectomy for PDR by a single surgeon treated with either cryotherapy or argon laser directly to the inner sclerostomy site at the completion of surgery (Treatment group). These were compared to a previous consecutive series of 82 eyes operated on by the same surgeon who did not have inner sclerostomy site treatment (Control group). The occurrence of any POVCH was recorded within the first 6 months of surgery.

Results: Composition of the two groups was similar in terms of age, indication for surgery and a variety of other preoperative factors. There were 64 patients in the control group and 65 in the treatment group. There was a significant reduction in the incidence of late recurrent POVCH in the treatment group. Late recurrent POVCH occurred in 12(15%) of eyes in the control group compared to 5(6%) in the treatment group (p=0.03). The numbers of eyes requiring revision surgery within the first 6 months for late recurrent POVCH was 4(5%) in the control group and 2(2.5%) in the treatment group (p=0.31).

Conclusion: This study suggests that inner sclerostomy site treatment is effective in reducing the occurrence of recurrent late POVCH in patients undergoing vitrectomy for PDR. A randomised controlled study is needed to clarify this.

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