Vitrectomy in eyes with diabetic retinopathy and light perception vision: A comprehensive outcome analysis

Abstract

Purpose

To evaluate the outcome of PPV in PDR patients with a Light Perception (LP) visual acuity at the time of signing up for surgery.

Methods

This retrospective study reviewed patient records from Harbor-UCLA and Olive View Medical Centers between March 2018 and March 2022. 32 patients (32 eyes) with LP visual acuity prior to surgery were included. Preoperative, intraoperative, and postoperative data were collected. Visual outcomes were assessed at 3 months (POM3), 6 months (POM6), and final follow-up. Statistical analyses included paired T-tests for visual acuity comparisons, linear regression for outcome predictors, and logistic regression for macular detachment risk factors.

Results

Significant visual improvement at POM3 (BCVA 20/660) and POM6 (BCVA 20/890) were observed compared to baseline, with a final follow-up BCVA of 20/600. At final follow-up, 37.5% of patients showed no improvement, with 12.5% experiencing No Light Perception (NLP). Multivariable analysis identified longer surgical duration as a significant negative predictor of achieving BCVA of 20/100 or better. Preoperative rhegmatogenous retinal detachment and a higher number of prior vitrectomies were associated with lower odds of maintaining retinal attachment at 6 months.

Conclusions

PPV provides a significant improvement in visual acuity for many patients with advanced PDR. However, a substantial portion of patients experience minimal or no improvement. Identified predictors of poorer outcomes can guide preoperative counseling and decision-making. This study highlights the need for careful consideration of surgical risks and benefits in advanced PDR cases.