Purpose: To evaluate prognostic factors for visual outcome in patients with diabetes
who have undergone vitrectomy (PPV) for severe proliferative diabetic vitreoretinopathy
(PDVR) in at least one eye in the past 15 years. Methods: Medical records of 132 eyes
of 66 patients were analyzed (median age 52 years 21–80; patients with type 1/2 diabetes
40/26; median follow-up 38 months 9–125). Correlations between final favorable visual
outcome defined as 0.5≤ best-corrected visual acuity (BCVA) and prognostic factors
(age, sex, type and duration of diabetes, metabolic status, BCVA, diabetic retinopathy
status, data of preoperative management, data of vitrectomy, and postoperative complications)
were analyzed. Results: BCVA improved significantly in the entire study cohort (from
median 0.05 min–max 0.001–1 to 0.32, 0.001–1, p < 0.001). Visual stabilization was
achieved in the majority of patients, and good visual acuity (0.5 ≤ BCVA) was maintained
in more than one-third of the eyes. Multivariable GEE statistics showed that in addition
to the duration of diabetes and stable HbA1c values, only preoperative tractional
macular detachment proved to be an independent significant predictor of visual outcome.
Conclusions: Pars plana vitrectomy is a useful tool when performed early before tractional
macular detachment. However, long-term visual stability can only be achieved with
good metabolic control.
