Bimanual Pars Plana Vitrectomy for Diabetic Tractional Retinal Detachment

Background: Diabetic retinopathy (DR) is considered the commonest cause of diabetic epiretinal membrane (ERM) worldwide. DR remains one of the leading causes of legal blindness in the working- age population. Aim of the work: was to evaluate the efficacy, safety and complications of bimanual pars plana vitrectomy (PPV) for management of ERM associated with tractional retinal detachment (TRD). Patients and methods: 27 eyes in 23 patients presented with diabetic ERM associated with TRD. After full ophthalmic examination all patients underwent bimanual PPV with silicone oil injection or gas tamponade without or with phacoemulsification and posterior chamber intraocular lens (IOL) implantation. Results: Complete removal of ERM was achieved in 23 cases (85.18 %) while has incompletely removed in four cases (14.81%). Residual tractional RD was observed in one cases (3.7%). Iatrogenic breaks were occurred in five cases (18.51%). Endo-laser photocoagulation was done in 19 cases (70.73%). There was improvement of BCVA in 23 (85.18%) cases, while remained the same in two cases (7.4%) and deteriorated in two eyes (7.4%) due to reproliferation and development of neovascular glaucoma. Conclusion: It could be concluded that bimanual PPV is an effective, safe and an attainable technique for management of diabetic ERM associated with TRD, learning curve with this technique and coast benefit ratio may be considered.