Poster Zbiba Walid

Goals:

The aim of our study was to evaluate the clinical characteristics, the results of surgery and the functional prognosis factors of combined tractional and rhegmatogenous retinal detachment in diabetic patients.

Methods:

Retrospective study of 32 eyes of 32 diabetic patients who underwent vitrectomy for combined tractional retinal detachment. Extension of fibro vascular proliferation was classified according to its severity. The results were evaluated after a follow up of 6 to 72 months (average 27 months).

Results:

The age of patients ranged from 28 to 72 years with a mean of 53.8 ±9.64. The mean duration of diabetes was 17.3 years, (3 to 26 years). The preoperative visual acuity ranged from light perception to 1/10. 81.25% of patients had a visual acuity less than 1/20. Iridis neovascularization was found in one patient. Vitreous hemorrhage was present in 40.62%. Retinal scatter photocoagulation was incomplete in 62.5% of cases and absent in 25% of eyes. The macula was detached in 81.25%. The retinal hole was unique in 62.5% and were identified in 16 eyes (50%) during surgery. Severe fibro vascular proliferation were noted in 20 cases (62.5%). Intraocular tamponade with C3F8 was used in 6.25% and with silicone oil in 93.75% of cases. 96.87% of eyes achieved retinal reattachment. It was obtained after a single intervention in 84.37% of cases. The silicone was retained in 21.87% of eyes. Visual acuity improved in 22 eyes (68.75%), was unchanged in 6 eyes (18.75%) and became worse in 4 eyes (12.5 %). Two preoperative factors were associated with a worse prognosis for achieving a final acuity of 20/800 or better: preoperative visual acuity <1/50 and preoperative detachment of the macula.

Conclusion:

With advances in microsurgical techniques, the anatomical results of combined retinal detachment improved, but functional prognosis is still poor.