PROLİFERATİV DİABETİK RETİNOPATİYANIN FƏSADLARI ZAMANI 23 VƏ 25 GAUGE PARS PLANA VİTREKTOMİYANIN NƏTİCƏLƏRİNİN MÜQAYİSƏSİ

Xülasə

SUMMARY

Aim – to study anatomical, functional results and complications of 23 and 25 gauge vitrectomy for various complications of diabetic retinopathy.

Material and methods
Results of pars plana vitrectomy in 121 eyes (121 patient), performed for complications of diabetic retinopathy in the department of diabetic eye disease of National Centre of Ophthalmology named after acad. Zarifa Aliyeva, Baku in 2014-2015 were analyzed. 23 gauge vitrectomy was performed in 90 eyes (90 patients), 25 gauge vitrectomy – in 31 eyes (31 patients). There were no statistically signifcant differences between groups for gender, age, diabetes type and HbA1c level (p>0,05). Minimum duration of follow-up period was 6 months.

Results
Combined surgery (phacoemulsifcation with IOL implantation and vitrectomy) was done in 29 eyes (32,2%) in the 23 gauge vitrectomy group and in 11 eyes (35,5%) in the 25 gauge vitrectomy group (p=0,739). Iatrogenic tears during surgery were observed in 11 eyes (12,2%) in the 23 gauge group and in 5 eyes (16,1%) in the 25 gauge group (p>0,05). At least one sclerotomy was sutured in 41 eyes (45,6%, of which 24 were with silicone oil tamponade) in the 23 gauge group and 8 eyes (25,8%, 7 with silicone oil tamponade) (p=0,041). Anatomical success (retinal attachment) was observed in the end of follow-up period in all eyes in both groups. Mean LogMAR visual acuity improved in both groups 6 months and 1 year after primary surgery (after 6 months in the 23 gauge group from 1,63±0,74 to 0,81±0,36, in the 25 gauge group from 1,78±0,80 to 0,68±0,35) (p=0,085). 3 eyes in the 23 gauge group (3,3%) showed hypotony (IOP≤5 mm Hg) on the 1st day after surgery (2 of them with recurrent hemorrhage).

Conclusion
Both 23 gauge and 25 gauge vitrectomy show satisfactory results after vitrectomy for various complications of diabetic retinopathy. Data received from the study allow us to expect wider use of 25 gauge vitrectomy in surgical management of diabetic retinopathy in future, including the most complicated manifestations as tractional and combined tractionalrhegmatogenous retinal detachment, along with improvements in the arsenal of instruments and vitrectomy technology.