Diabetic Vitrectomy in Both Eyes

DR almost always affects both eyes. Despite recent rapid progress in the medical treatment of diabetic patients and advances in laser and pharmacological therapies for diabetic retinopathy (DR), particularly the wide application of anti-vascular endothelial growth factor (VEGF) agents, many DR patients still require surgery to preserve visual function. The severity of DR in both eyes may not be symmetric, and approximately 5–10% of DR patients have an asymmetric presentation and progression (Azad et al., Indian J Ophthalmol, 69(11): 3026–34, 2021, https://doi.org/10.4103/ijo.IJO_1525_21 ). It is not uncommon to perform surgery on one eye, but the patient’s fellow eye is treated conservatively (Berrocal et al., J Clin Med, 11(18), 5399, https://doi.org/10.3390/jcm11185399 ). However, it is equally possible that both eyes develop severe DR either concurrently or sequentially, which requires surgery. Previous studies have demonstrated that approximately 20–38% of patients require vitrectomy in the fellow eye after surgery in the first eye (Sulak et al., Retina, 38(4): 698–707, https://doi.org/10.1097/IAE.0000000000001589 , 2018; Hwang et al., Br J Ophthalmol, 97(3), 297–301. https://doi.org/10.1136/bjophthalmol-2012-302233 , 2013; Vote et al., Clin Exp Ophthalmol, 32(4): 397–403. https://doi.org/10.1111/j.1442-9071.2004.00845.x , 2004; Smiddy et al., Ophthalmology, 102(11): 1688–95. https://doi.org/10.1016/s0161-6420(95)30808-1 , 1995). In our study, the visual prognosis of patients who received bilateral vitrectomy, the potentially blinding condition, and the differences in disease severity and outcomes between the concurrent and sequential groups and between the first- and second-operated eyes will be presented and discussed.