Comparison of persistent submacular fluid in different preoperative macular status after vitrectomy for rhegmatogenous retinal detachment

AIM: To compare the incidence of persistent submacular fluid(SMF) and visual outcome after pars plana vitrectomy(PPV) for rhegmatogenous retinal detachment(RRD) in different preoperative macular status according to optical coherence tomography(OCT).METHODS: A non-randomized, retrospective review was performed for patients who underwent successful PPV for RRD. OCT exams were taken preoperatively and 1 mo after surgery, until SMF disappeared. According to the preoperative macular status on OCT, patients were divided into two groups: macula-off RRD(Group A) and maculaon RRD(Group B). In Group A, there were two subgroups: macula partly detached(Group A1) and macula totally detached(Group A2). The main outcome measures were the presence of SMF on OCT 1 mo after surgery, and the preoperative and postoperative best corrected visual acuities(BCVA), among the different groups and depending on the presence or absence of persistent SMF.RESULTS: A total of 139 eyes of 139 patients were included in the study. Persistent SMF at 1 mo after surgery was 15.8%(22/139), all occurring in Group A(22/101); Group B had no SMF at 1 mo after surgery(0/38, P=0.002). The incidence of persistent SMF at 1 mo after surgery in Group A1 was 50%(14/28), and in Group A2 was 11.0%(8/73, P<0.001). Significant differences were shown between the presence and absence of persistent SMF on foveolaoff RRD, the preoperative BCVA, the 1 mo postoperative BCVA, and the degree of the BCVA improvement from 1 mo postoperatively to the final follow-up(P<0.05). However, there were no significant differences in the final BCVA(P>0.05).CONCLUSION: Persistent SMF after PPV for retinal detachment is associated with preoperative macular status. Macula-uninvolving RRD shows no persistent SMF after PPV. Macular partly detached RRD has a higher incidence of SMF than macula totally detached RRD after PPV. The persistence of SMF may be responsible for the delayed visual recovery, whereas there were no significant differences in the final visual acuity.

Effect of intravitreal conbercept treatment before vitrectomy in proliferative diabetic retinopathy

● AIM: To evaluate the safety and efficacy of intravitreal conbercept(IVC) injections as pretreatment for pars plana vitrectomy(PPV) in severe proliferative diabetic retinopathy(PDR).● METHODS: This was a retrospective chart review of all patients who underwent PPV for PDR from January 2014 to October 2016. Patients who underwent IVC injection before PPV were assigned to the IVC group; the others were assigned to the control group. The IVC was performed 3-7 d before surgery in the IVC group. All the eyes in the two groups were operated by the same doctor to complete the vitrectomy. Intraoperative complications and the changes in best-corrected visual acuity(BCVA) before and after surgery were compared between the two groups.● RESULTS: A total of 68 eyes of 63 patients(22 eyes in the IVC group and 46 eyes in the control group) were examined. The risk of intraoperative bleeding was lower in the IVC group(2/22) than in the control group(25/46, P=0.000). Furthermore, the use of endodiathermy was significantly lower in the IVC group(1/22) than in the control group(12/46, P=0.047). The surgical time in the IVC group(112.64±34.52 min) was significantly shorter than in the control group(132.85±40.04 min, P<0.05). Compared to the BCVA before surgery, the mean BCVA was significantly improved after surgery for both groups(P<0.05).● CONCLUSION: PPV is an effective treatment and can improve vision in patients with PDR. Preoperative intravitreal injection of conbercept could reduce the chances of intraoperative bleeding and the use of endodiathermy and shorten the operative time, which are beneficial in the management of PDR.