Panretinal photocoagulation during vitrectomy for diabetic vitreous hemorrhage: A clinical trial comparing endolaser application amounts.

Purpose: To evaluate the effectiveness of different endolaser photocoagulation treatment amounts during pars plana vitrectomy (PPV) in patients with a vitreous hemorrhage (VH) secondary to proliferative diabetic retinopathy (PDR).

Design: Randomized clinical trial METHODS: One hundred and forty-four treatment-naïve PDR patients with an ocular media-obscuring VH were enrolled into this clinical trial. Participants were randomized into one of two possible treatment groups: Group A subjects underwent PPV and received 250 + /- 50 endolaser applications during surgery, while Group B subjects underwent PPV and received 550 + /- 50 endolaser applications during surgery. The primary outcome was the rate of postoperative VH, and the secondary outcome was visual acuity at 6 months.

Results: Ninety-one patients underwent PPV and completed the 6-month trial period. Group A had 30.0 % (15/50) of participants develop a postoperative VH, while Group B had 12.2 % (5/41) of subjects develop a postoperative VH at 6 months (P = 0.002). The visual acuity of 0.4 (0.23-0.57) logMAR (Snellen 20/50) in Group B was better than that of 0.79 (0.58-1.01) logMAR (Snellen 20/120) in Group A at the end of the 6 month trial period (P = 0.006).

Conclusions: Treatment-naïve PDR subjects undergoing PPV for an ocular media-obscuring VH have a lower incidence of postoperative VH and better visual acuity at 6 months when 550 + /- 50 endolaser applications were administered compared to 250 + /- 50 endolaser applications during PPV. Further research is warranted on this topic to verify the generalizability of these findings to a broader PDR population.