To the Editor.
—In the August Archives Shea1 reported on his experience with early vitrectomy in proliferative diabetic retinopathy, stating that "The most advantageous time to carry out pars plana vitrectomy in proliferative diabetic retinopathy is when elevated neovascularization (ie, partial vitreous detachment) is present before the occurrence of substantial visual loss or traction detachment." Although these results generally agree with the experience of most vitreous surgeons, Shea does not report the rate of visual loss. Although progression to 20/200 or worse in 24.9% of eyes (all of which had visual acuities of 20/100 or better preoperatively) may be acceptable, it is not acceptable if this visual loss occurs shortly after surgery.Information concerning this dreaded outcome (accelerated decompensation after surgery) would help us evaluate the role of vitrectomy in diabetic patients with useful vision.
Hanscom T. Early Vitrectomy. Arch Ophthalmol. 1984;102(4):507. doi:10.1001/archopht.1984.01040030393003