Purpose. To evaluate the long-term efficacy of laser photocoagulation and pars-plana vitrectomy in young diabetics affected by florid proliferative retinopathy. Methods. We followed 118 eyes of 66 diabetic patients for a mean time of 46.4 months ± 36.3. The clinical characteristics of the patients were: 46 (69,7%) females; mean age 26.7 years ± 5.0; mean duration of diabetes mellitus 16.2 years ± 5.0; coexisting high blood pressure in 17 (25.7%) patients. All of them were insulin-dependent (100%). Mean initial visual acuity was 0.64 ± 0.27. In all the eyes a confluent panretinal photocoagulation extended to all areas of retinal ischemia was performed. Twenty-eight eyes (23.7%) were submitted to pars-plana vitrectomy. Results. At the end of the follow-up visual acuity was 0.47 ± 0.33. Eyes with a final visual acuity lower than 0.1 were 25 (21.2%). The causes of blindness, in the majority of cases (90.4%), were retinal detachment and vitreous hemorrhages. The mean post-surgical visual acuity was 0.18 ± 0.24 Considering the total number of eyes, diabetic retinopathy improved in 81 out 118 eyes (68.6%); on the contrary in 31.4% of the eyes retinopathy appeared worsened. Neovascular glaucoma occurred in 7 (5.9%) eyes. Conclusions. Although florid retinopathy remain the major cause of blindness in diabetics, early laser treatment and pars-plana vitrectomy may reduce this risk.
|Journal||Investigative Ophthalmology and Visual Science|
|Publication status||Published - Feb 15 1996|
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