Early vitrectomy may prevent further vision loss in proliferative diabetic retinopathy




Boscia F. Early pars-plana vitrectomy for complications of proliferative diabetic retinopathy. Presented at: World Retina Congress; May 12-15, 2022; Fort Lauderdale, Florida.

Disclosures: Boscia claims to be a consultant for Alcon, Allergan, Bayer and Novartis.

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FORT LAUDERDALE, Fla. — Early pars plana vitrectomy could be an inexpensive, definitive treatment for patients with proliferative diabetic retinopathy, according to a speaker at the World Retina Congress.

Francesco Boscia, MD, said the indications for early vitrectomy have traditionally been in patients at high risk of threatened vision, including those with dense vitreous premacular hemorrhage, macular traction detachment and other complications.

Francesco Boscia

“This was primarily due to the risk of surgery in the 20-gauge era and the cost associated with multiple surgical approaches,” he said.

Boscia said the retina community has recently realized that even under the best of circumstances, treatments such as panretinal photocoagulation or ranibizumab therapy are not always effective in preventing the progression of proliferative diabetic retinopathy (PDR) and the need for vitrectomy.

Advances in early, small-bore vitrectomy have provided surgeons with better tissue separation and more control, Boscia said.

In a recent study, Boscia and colleagues looked at 38 patients who underwent early vitrectomy for PDR and observed clinically significant progression in visual acuity, a finding that was consistent with other recent studies, he said. declared.

“There is a significant rate of subsequent treatment with an initial laser or intravitreal anti-VEGF, and this, combined with the low degree of compliance in this population, actually supports the early vitrectomy approach for diabetic retinopathy,” said Boscia said. “[Early vitrectomy] could be a definitive treatment for ROP, preventing further vision loss. »


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