Enhancing the outcomes of diabetic vitrectomy with pharmacological adjuvants

Table 1 Comparison of novel and traditional treatment modalities for diabetic retinopathy: Advantages and disadvantages

Treatment modality	Advantages	Disadvantages	Ref.
Novel: Pharmacological adjuvants in vitrectomy	Enhances vitreous clarity, improving surgical visibility; mitomycin C and other agents can improve functional outcomes	Adverse effects such as retinal toxicity in some cases; not universally adopted	Venkatesh et al[1], 2024; Gurelik et al[3], 2024
Novel: Anti-VEGF therapy	Reduces neovascularization and macular edema; short-term reduction in angiogenic and fibrotic factors in fibrovascular membranes	Requires repeated injections; potential ocular pain with multiple intravitreal injections	Fadakar et al[2], 2024; Zhou et al[14], 2024; Damasceno et al[17], 2024
Novel: Hyaluronan hydrogel adjuvant in vitrectomy	Facilitates easier removal of posterior vitreous cortex; biocompatible and injectable, improving surgical outcomes	Still under clinical evaluation; potential complications in certain patients	Hisatomi et al[5], 2024; Suzuki et al[7], 2023
Novel: Conbercept and ranibizumab pre-vitrectomy	Enhances anatomical outcomes by reducing vitreous hemorrhage; improves outcomes in complex cases such as neovascular glaucoma	Costly and not universally accessible; timing of administration critical for efficacy	Gao et al[6], 2023; Yang et al[8], 2023; Wang et al[16], 2023
Traditional: Laser photocoagulation	Well-established, reduces risk of vision loss from proliferative diabetic retinopathy	Can cause permanent retinal scarring; limited effect on macular edema	Venkatesh et al[1], 2024; Chauhan et al[18], 2024
Traditional: Pars plana vitrectomy	Effective in treating advanced proliferative diabetic retinopathy; can remove vitreous hemorrhage and fibrovascular tissue	High risk of complications, including postoperative vitreous hemorrhage; prolonged recovery period	Mansour et al[13], 2023; Rohowetz et al[19], 2024; Thapa et al[20], 2024
Traditional: Intravitreal steroids	Reduces inflammation and macular edema; long-lasting effect compared to anti-VEGF	Increases risk of intraocular pressure elevation; risk of cataract formation	Salvetat et al[12], 2024; Wang et al[15], 2024

This table compares the advantages and disadvantages of novel and traditional treatments for diabetic retinopathy. Novel therapies, including pharmacological adjuvants and anti-vascular endothelial growth factor agents, offer advancements in managing complications but may involve higher costs and specific risks. Traditional approaches, such as laser photocoagulation and pars plana vitrectomy, remain effective but have limitations, including retinal scarring and extended recovery times. References are provided for further review of the supporting evidence. VEGF: Vascular endothelial growth factor.