Retinal Detachment After Diabetic Vitrectomy

Post-DV RD is a major complication after surgery. Approximately 1–20% of patients develop RD after DV for FVP (Schachat et al., Ophthalmology 90(5):522–530, 1983; Smiddy and Flynn, Surv Ophthalmol 43(6):491–507, 1999; La Heij et al., Graefes Arch Clin Exp Ophthalmol 242(3):210–217, 2004; Jackson et al., JAMA Ophthalmol 134(1):79–85, quiz 120, 2016; Yau et al., Semin Ophthalmol 33(1):126–133, 2018; Schrey et al., Retina 26(2):149–152, 2006). The risk of severe proliferation is high because of surgical difficulties and the excessive manipulations needed. New breaks, missed breaks, or proliferation from residual fibrovascular tissue or newly developed preretinal tissue may be the underlying causes (Smiddy and Flynn, Surv Ophthalmol 43(6):491–507, 1999; Yau et al., Semin Ophthalmol 33(1):126–133, 2018; Sternfeld et al., Clin Ophthalmol 9:1989–1994, 2015). Because of the preproliferative microenvironment and compromised choroidal and retinal circulation, recurrent RD after vitrectomy for PDR usually has poor anatomical and functional prognoses (Castellarin et al., Br J Ophthalmol 87:318–321, 2003). The detachment can have various manifestations and severities. There are few studies specifically focusing on this topic (Schrey et al., Retina 26(2):149–152, 2006; Brown et al., Arch Ophthalmol 110(4):506–510, 1992; Abdelhadi et al., Clin Ophthalmol 14:53–60, 2020). Different presentations and treatment options, as well as prognoses, will be discussed in this chapter.