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World J Methodol. Dec 20, 2024; 14(4): 92246
Published online Dec 20, 2024. doi: 10.5662/wjm.v14.i4.92246
Pharmacological adjuvants for diabetic vitrectomy surgery
Ramesh Venkatesh, Chaitra Jayadev, Vishma Prabhu, Priyanka Gandhi, Rupal Kathare, Naresh K Yadav, Ayushi Choudhary, Jay Chhablani
Ramesh Venkatesh, Department of Ophthalmology, Narayana Nethralaya, Bangalore 560010, India
Chaitra Jayadev, Vishma Prabhu, Priyanka Gandhi, Rupal Kathare, Ayushi Choudhary, Department of Retina, Narayana Nethralaya Eye Institute, Bangalore 560010, India
Naresh K Yadav, Department of Vitreo Retina, Narayana Nethralaya, Retina Serv, Super Specialty Eye Hospital and Post Graduate Institute of Ophthalmology, Bangalore 560010, India
Jay Chhablani, Department of Retina, University of Pittsburg School of Medicine, Pittsburg, PA 15213, United States
Author contributions: Venkatesh R writing, critical review and revising the manuscript; Jayadev C, Prabhu V, Yadav NK reviewing the manuscript; Gandhi P, Kathare R, Choudhary A assisting in writing the manuscript; Chhablani J critical review of the manuscript.
Conflict-of-interest statement: None of the authors have anything to declare.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ramesh Venkatesh, MBBS, MD, MS, Doctor, Surgeon, Department of Ophthalmology, Narayana Nethralaya, 121/C. 1st R block, West of Chord Road, Rajaji Nagar, Bangalore 560010, India. vramesh80@yahoo.com
Received: January 20, 2024
Revised: June 26, 2024
Accepted: July 5, 2024
Published online: December 20, 2024
Processing time: 188 Days and 6.9 Hours
Abstract

Diabetic vitrectomy is a highly intricate surgical procedure performed during the advanced stages of diabetic retinopathy (DR). It is used to treat conditions such as tractional or combined retinal detachment, vitreous hemorrhage, and subhyaloid hemorrhage, which are all severe manifestations of proliferative DR. The results of the surgery are uncertain and variable. Vitreoretinal surgery has made significant progress since the early stages of vitrectomy. In the past ten years, advancements in intravitreal pharmacotherapy have emerged, offering new possibilities to improve the surgical results for our patients. Within the realm of medical terminology, an "adjunct" refers to a pharmaceutical or substance employed to aid or expedite the primary therapeutic intervention for a particular ailment. Their introduction has broadened the range of therapeutic choices that are accessible prior to, during, and following surgical procedures. This review article will specifically analyze the pharmacological adjuncts used in diabetic vitrectomy surgery, with a focus on their role in facilitating or aiding specific steps of the procedure. The implementation of this system of categorization offers benefits to the surgeon by allowing them to foresee potential difficulties that may occur during the surgical procedure and to choose the appropriate pharmacological agent to effectively tackle these challenges, thus enhancing surgical success rates.

Keywords: Diabetic retinopathy; Vitrectomy; Intravitreal injections; Anti-vascular endothelial growth factor; Adjuvants; Outcomes

Core Tip: For advanced diabetic retinopathy, diabetic vitrectomy is a complex procedure with unpredictable outcomes. In the last decade, intravitreal pharmacotherapy has advanced, providing new ways to improve surgical outcomes for our patients. In medicine, an "adjunct" refers to a drug or substance that supplements the main treatment. This review will look at the pharmacological adjuncts used in diabetic vitrectomy surgery and how they affect specific steps. The categorization system enables surgeons to anticipate surgical issues and select the appropriate pharmacological agent to address them, thereby increasing surgical success rates.