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Philip James Banerjee, Rene Moya, Catey Bunce, David G Charteris, David Yorston, Louisa Wickham; Long-term survival rates of patients undergoing vitreous surgery for proliferative diabetic retinopathy. Invest. Ophthalmol. Vis. Sci. 2014;55(13):5360.
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Reported five-year survival rates in patients undergoing vitreous surgery for proliferative diabetic retinopathy (PDR) range from 68 to 85%. Studies relating survival rates to medical baseline characteristics predate the millennium. The aim of this study was to update data on life expectancy of patients undergoing vitrectomy surgery for PDR and identify any baseline factors which may influence their survival.
An observational cross-sectional study of consecutive patients who underwent their first pars plana vitrectomy for proliferative diabetic retinopathy from April 2004 to May 2005 was performed. Kaplan-Meier life table method was used to determine survival rates. Univariate and multiple variable regression analysis using the Cox proportional hazard model were used to identify risk factors for mortality.
148 patients were included in the study, with a mean age of 53 years (range 20-80) at time of surgery. The 3, 5 and 7 year survival rates were 94%, 86% and 77%, respectively (95% Confidence Intervals 88-97%, 79-91% and 68-84%). Renal failure was the most common cause of death, accounting for one third of cases. The presence of limb ulcers at the time of surgery was the most important prognostic indicator for mortality with a hazard ratio of 3.3 (p=0.002, 95% CI 1.52-7.07) and a survival rate at five years reduced to 73%.
The five year survival rate remains comparable to those reported twenty years ago. The presence of limb ulcers is strongly associated with increasing mortality. Clinicians should remain mindful of the systemic associations of diabetes particularly in advanced retinal disease.
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