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Suruchi Bhardwaj, Edmund Tsui, Nitish Mehta, Joseph Tseng, Kenneth Wald; Post-Vitrectomy Outcomes in Patients With Type 1 and 2 Diabetes Mellitus With Vitreous Hemorrhage. Invest. Ophthalmol. Vis. Sci. 2016;57(12):6358.
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To analyze the characteristics and post-op outcomes in patients with Diabetes Mellitus who underwent a vitrectomy and developed post-op vitreous hemorrhage(VH)
A retrospective chart review was performed for all patients who were diagnosed with VH between June 2014 to Nov 2015. Patients were further included who were diagnosed with diabetes mellitus and had a vitrectomy with a minimum three month follow up.87 eyes of 81 patients were selected
Of the 87 eyes,9(10%) were found to have significant VH immediately after surgery, defined as VH obscuring the posterior pole within 1 week of surgery.6 of 9(67%) eyes had improved visual acuity by day 90.2 of 9(22%) did not improve in visual acuity by day 90.1 of 9(11%) eyes experienced worsening in vision by day 90. 6 of 9(67%) eyes had clearance of VH by 90 days,8 out of the 9(89%)eyes had a POD1 visual acuity of 20/200 or worse.5 out of 9(56%) eyes had post-op IOP elevation requiring medication.6 out of 9(67%) had received PRP or anti-VEGF injections prior to surgery.1 out of 9(11%)significant VH eye underwent re-operation.78 out of 87(90%) eyes were did not have significant VH. 63 of 78(81%)improved visual acuity by day 90. 11 of 78 eyes had unchanged vision by day 90.4 of 78(5%)had worsening of vision by day 90. 56 of 78(72%) eyes had VH clearance by 90 days. 55 of 78 (71%)eyes had a POD1 visual acuity of 20/200 or worse.15 of 78(19%) eyes experienced a post-op IOP elevation.58 of 78(74%) eyes underwent PRP or received injections before surgery. 7 out of 78(9%) underwent re-operation
Both groups were able to achieve VH clearance by 90 days at a comparable level(67 vs 72%)Eyes with significant VH were more likely to have a pre-op traction retinal detachment and post-op IOP elevation.A large portion of patients in both groups underwent PRP or received intra-vitreal injections prior to surgery.A larger proportion of patients experienced improvement in vision by day 90 in the non-significant VH group(81% vs 67%).More eyes in the significant VH group had a POD1 visual acuity worse than 20/200.Both groups achieved a comparable VH clearance rate and visual acuity improvement rate.It is possibly that POD1 visual acuity was not a predictor of final vision.There was no real difference noted between the two groups in terms of preclinical factors and post-surgical outcomes.Further research with a larger population size is warranted
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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