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The following is a summary of “Elucidating postoperative dynamics in tractional retinal detachment: a systematic review and meta-analysis of structural and functional outcomes following diabetic vitrectomy, including an analysis of postoperative complications,” published in the December 2024 issue of Ophthalmology by Quiroz-Reyes et al.
Researchers conducted a retrospective study to evaluate the efficacy and safety of diabetic vitrectomy in treating tractional retinal detachment (TRD), focusing on visual acuity improvements, retinal reattachment success rates, and postoperative complications.
They identified 1,211 studies, with 30 meeting the inclusion criteria for analysis. Meta-analyses were performed using random effects models to account for heterogeneity. Primary outcomes were visual acuity improvement and retinal reattachment success, while postoperative complications were secondary outcomes. Funnel plots, trim-and-fill methods, and Egger’s regression tests were used to assess and adjust for publication bias. Data from 1,844 eyes across 30 studies were included.
The results showed a pooled mean difference (MD) in visual acuity of 0.80 logMAR (95% CI: 0.58–1.01, P < 0.0001), with high heterogeneity (I2= 95%). After adjusting for publication bias, the MD was 1.15 (95% CI: 0.85–1.45). The pooled retinal reattachment success rate was 94.63% (95% CI: 90.88–96.89%), with substantial heterogeneity (I2= 82.2%). Egger’s regression test confirmed publication bias in retinal reattachment data (t = 6.07, df = 25, P < 0.0001). Common postoperative complications included vitreous hemorrhage (8.2%, 0–41%), elevated intraocular pressure (7.3%, 0–25%), and cataract formation (10.3%, 0–43%).
Investigators concluded the diabetic vitrectomy significantly improved visual acuity and retinal reattachment success in patients with TRD despite heterogeneity across studies and also noted the need for better reporting of perfusion markers and standardization of surgical techniques to improve future research and clinical outcomes.
Source: bmcophthalmol.biomedcentral.com/articles/10.1186/s12886-024-03820-z
