Bimanual technique in proliferative diabetic retinopathy using an optical fiber-free intravitreal surgery system: a case control study.

PURPOSE To evaluate the results of bimanual membrane peeling technique with an optical fiber-free intravitreal surgery system (OFFISS) in eyes with fibrovascular proliferation due to diabetic retinopathy. METHODS Fifteen eyes of 14 consecutive patients with severe fibrovascular proliferation due to diabetic retinopathy who underwent bimanual vitrectomy using the OFFISS and 15 eyes of 15 nonconsecutive patients with similar fundus condition who underwent vitrectomy using a conventional microscope system were compared in a retrospective, consecutive case control series. RESULTS Reattachment rates at 3 months following surgery for the cases and controls were 93% and 100%, respectively, and final reattachment rates for both were 100%. The best corrected visual acuity improved by two lines or more in 100% of the cases as compared to 87% of the controls (p=0.48). The mean VA (logMAR) improved 1.08 in the cases and 0.93 in the controls at final examination (p=0.46). Surgical complications were rare in both groups (p>0.05). The mean duration of membrane peeling of the cases was significantly lower than the controls (p=0.01). CONCLUSIONS For complicated surgical manipulations such as membrane peeling in diabetic vitrectomy for severe fibrovascular proliferation, bimanual vitrectomy using the OFFISS is a more effective and safer alternative to the conventional vitrectomy method.