Abstract / Summary
Abstract Purpose : To evaluate the long-term outcomes of 25G pars plana vitrectomy (PPV) for diabetic tractional retinal detachment (TRD). Methods : This retrospective study included eyes with diabetic type 1 or 2 TRD, excluding cases with preoperative intravitreal hemorrhage or prior vitrectomy. Outcomes assessed included best-corrected visual acuity (BCVA), retinal reattachment rate, need for additional surgery, and postoperative complications. Results : A total of 124 eyes from 116 patients with TRD were included. The mean postoperative follow-up was 19.9 ± 17.1 months. Before surgery, 55.6% (69 eyes) had macula-off detachment. The mean BCVA improved significantly from the initial postoperative visit and remained stable throughout follow-up (p<0.001). Preoperatively, 46 eyes had moderate-to-severe visual impairment, while 56 were legally blind. Postoperatively, 54 eyes remained in the moderate-to-severe impairment category, and legally blind eyes decreased to 22. Primary reattachment was achieved in 93.5% of cases, increasing to 99.2% with additional surgeries. Postoperative complications were vitreous hemorrhage (12.9%), elevated intraocular pressure (5.7%), iris neovascularization (2.4%), epiretinal membrane (4%), and full-thickness macular hole (2.4%). Conclusion : Twenty-five–gauge PPV for diabetic TRD demonstrated high anatomical success, significant visual improvement, and a low complication rate. Early surgical intervention, particularly before foveal involvement, is recommended to optimize visual outcomes and minimize complications.