Ten Pearls for Performing Vitrectomy in Diabetic Retinopathy
Important terms: Truncation: To relieve all the surrounding traction 360 degree Segmentation: Dividing a larger membranes/FVP into smaller islands of FVP by 360-degree truncation around them. Delamination: Separation of these membranes/FVP from the retinal surface to which they are firmly adherent by creating a plane of dissection between them. Pearl #1 When not to perform vitrectomy in diabetic retinopathy? Answer: In cases of extramacular tractional retinal detachment (TRD) when the fovea is attached and the patient has a comparative good vision the extramacular TRD can be observed. Charles and Flinn reported only 21% of extramacular TRD extending into macula without any surgical intervention. Also, DRVS (Diabetic retinopathy vitrectomy study) reports that only 23% of eyes with TRD developed severe visual loss at 2 years. Also, early intervention in such extramacular TRD’s can sometimes lead to more harm than benefit owing to the surgery itself. Pearl #2 First step should always be c

