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Nora Khatib, Dhanu Meleth, Robert Garoon, Cindy Hwang, Usha Pinninti, Golnaz Javey, Petros Carvounis; Recurrent Vitreous Cavity Hemorrhage Requiring Repeat Surgery in Diabetics following Vitrectomy for Complications of Proliferative Diabetic Retinopathy: Incidence, Visual Outcomes, and Associations. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):1743.
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To evaluate the incidence, visual outcomes and associations of recurrent vitreous cavity hemorrhage (VH) requiring repeat pars plana vitrectomy (PPV) in diabetic patients who had previously underwent PPV for complications of proliferative diabetic retinopathy (PDR).
Retrospective single center chart review study of eyes that underwent PPV for complications of PDR between June 2010 and December 2013. Group R included diabetic eyes requiring repeat PPV for recurrent VH following initial surgery for PDR and Group N included diabetic eyes that did not require additional surgical intervention after PPV for complications of PDR. Statistical comparisons were made using Student’s two-tailed t-test.
Of the 360 diabetic eyes that underwent PPV for complications of PDR, twenty (5.6%, Group R) had recurrent post-vitrectomy VH requiring repeat vitrectomy and 340 eyes (Group N) did not have persisting VH requiring additional intervention. There were no differences in mean HbA1c in Group R (7.8%, 5.4-11.8%) and Group N (8.3%, range 4.2 to 14.9%) (p=0.44). Average systolic blood pressure was 145.8 in Group R and 141 in Group N (p=0.31). Average final Snellen VA was 20/640 (logMAR 1.5) in Group R and 20/1000+2 (logMAR 1.66) in Group N (p=0.44).
A small proportion of patients undergoing vitrectomy for complications of PDR require repeat surgical intervention for recurrent VH. There was no clear association between HbA1c and systolic blood pressure and need for repeat PPV for recurrent VH after initial PPV for PDR. Glucose and blood pressure control do not appear to be predictors of additional surgical intervention for non-clearing VH after PPV for PDR. Final VA was similar between the two groups and does not appear to be affected by repeat surgical intervention and complications of PDR.
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