Pars Plana Vitrectomy for Proliferative Diabetic Retinopathy

Abstract

A patient needing vitreo-retinal surgery does so as a complication of the proliferative process (PDR). This results from either failure to detect proliferative retinopathy in time for laser photocoagulation to be effective (if there is no ophthalmic screening service in position all those in charge of diabetics must be adequately skilled in ophthalmoscopy, e.g. general practitioners and diabetologists) or failure of photocoagulation to control the process. The latter failure may be due either to non-co-operation, or to inadequate photocoagulation. It is rare for an eye that has been adequately treated with full photocoagulation to come to vitreo-retinal surgery. The majority of patients developing proliferative diabetic retinopathy are insulin dependent and will have had diabetes for many years. The appearance of PDR and other serious diabetic complications such as renal failure is less frequent in those who have had good diabetic control (as measured by blood sugar levels) than those whose control has been poor.