Aim To describe the rate of fellow eye vitrectomy for proliferative diabetic retinopathy in an inner city population.

Methods Retrospective interventional case series. Medical and surgical records of 434 consecutive eyes of 358 patients undergoing primary diabetic vitrectomy in an inner city institutional practice were reviewed. Kaplan–Meier statistical analysis was employed to evaluate the rate of fellow eye vitrectomy and visual outcomes were determined for patients with ≥3 months follow-up.

Results Fellow eyes underwent diabetic vitrectomy at a rate of 24% within 1 year, 34% within 3 years and 36% within 5 years of primary vitrectomy. A surgical indication of non-clearing vitreous haemorrhage (VH) in the primary eye was associated with a lower rate of fellow eye surgery compared with non-clearing VH with extrafoveal traction retinal detachment (TRD) at years 1, 3 and 5 (p≤0.02), and TRD at years 3 and 5 (p≤0.03). Younger patients underwent fellow eye vitrectomy at a higher rate than older patients (p≤0.01). Surgical intervention was associated with improvement in mean visual acuity (p<0.01).

Conclusions Approximately a third of fellow eyes required diabetic vitrectomy within 3 years of primary eye vitrectomy. Primary eye surgical indication and younger age were significant predictors of need for fellow eye surgery.