A Standardized 10-Step Algorithm for Vitrectomy in Diabetic Tractional Retinal Detachment

This review outlines a standardized surgical strategy for managing tractional retinal detachment (TRD) secondary to proliferative diabetic retinopathy. TRD remains a challenging complication due to dense fibrovascular adhesions, persistent posterior hyaloid traction, and a high risk of intraoperative bleeding and iatrogenic retinal breaks. A structured approach is essential to enhance surgical control and reduce complications. The technique emphasizes controlled vitreous removal, early hemostasis, identification of safe dissection planes, careful handling of fibrovascular tissue, and complete elimination of posterior hyaloid remnants. Visualization is optimized with selective adjuncts, followed by comprehensive laser treatment and systematic peripheral inspection to ensure retinal stability. By prioritizing deliberate tissue manipulation and thorough treatment of ischemic retina, this standardized method aims to minimize traction, prevent intraoperative and postoperative complications, and improve anatomical consistency in complex diabetic TRD cases. Although visual recovery remains limited by the underlying disease, applying a consistent and methodical strategy can enhance predictability and overall surgical outcomes.