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

Abstract

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.