VITRECTOMY IN DIABETIC-PATIENTS WITH A BLIND FELLOW EYE

Results of pars plana vitrectomy for complications of proliferative di abetic retinopathy were analysed in 32 consecutive patients with a bli nd fellow eye due to diabetic eye disease. The mean follow-up period w as 22.3 months. Only 16% of all eyes examined had received full scatte r photocoagulation prior to referral for vitrectomy. Out of 9 eyes wit h vitreous haemorrhage, 8 improved to a visual acuity of greater than or equal to 0.2 postoperatively. Amid 23 eyes which were vitrectomized for advanced traction retinal detachment, only 4 eyes improved to a p ostoperative visual acuity of greater than or equal to 0.02. In this g roup 12 eyes deteriorated after vitrectomy, 3 eyes progressing to no l ight perception, The postoperative visual outcome after vitrectomy for traction retinal detachment in this group of diabetics with a blind f ellow eye (mean postoperative visual acuity 0.03 +/- 0.05) was signifi cantly worse (p < 0.000) compared to a group of 196 patients with a se eing fellow eye who were vitrectomized for traction retinal detachment at our clinic (mean postoperative visual acuity 0.09 +/- 0.11). There fore we conclude that traction retinal detachment in this subgroup of patients is a particularly severe presentation of diabetic retinopathy with a guarded functional prognosis after vitrectomy. Our results dem onstrate the importance of timely full scatter photocoagulation and ea rly vitrectomy in eyes with progressive fibrovascular proliferation no t responding to panretinal photocoagulation. We conclude that especial ly diabetic patients with a blind fellow eye must be followed closely and assigned to vitrectomy at an earlier stage of their disease in ord er to improve functional prognosis.