Results of Vitrectomy for Proliferative Diabetic Retinopathy

The authors treated 1007 eyes with vitrectomy for complications of proliferative diabetic retinopathy. Indications for surgery were: (1) vitreous hemorrhage, 353 eyes (35%); (2) traction retinal detachment, 360 eyes (36%); (3) combined traction -rhegmatogenous retinal detachment, 172 eyes (17%); and (4) other progressive fibrovascular proliferation 122 eyes (12%). During the study period, the frequency of vitreous hemorrhage as an indication for surgery decreased from 42 to 25%, and other progressive fibrovascular proliferation increased from 5 to 22%. The frequency of traction and traction/rhegmatogenous retinal detachments did not change. The results of surgery varied according to the indication. Seventy-nine percent of eyes with vitreous hemorrhage obtained final vision of 5/200 or better. Similar results were obtained in 64% of eyes with traction detachment, 56% of eyes with rhegmatogenous detachment, and 81 of eyes with progressive fibrovascular proliferation. The percentage of eyes achieving final vision of 20/100 or better are as follows: (1) vitreous hemorrhage, 48%; (2) traction detachment, 27%; (3) rhegmatogenous detachment, 24%; and (4) progressive fibrovascular proliferation, 46%. The success rate improved in each anatomic category during the last 3 years of the study.