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Yvonne Hsu-Lin Luo, Rodolfo Mastropasqua, Lyndon da Cruz; Outcome Analysis of Diabetic Delamination Surgery by Ethnicity, Age and Gender. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):5115.
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To determine the outcomes of diabetic delamination surgery and examine the association with ethnicity, age and gender.
Retrospective casenote review of all diabetic patients who underwent vitrectomy / delamination between 2009-2013 in a tertiary referral center. Patient demographics: race, age and gender were recorded. Outcome measures were: best corrected visual acuity (BCVA), and retina anatomical stability (RAS) at 6 months post-op. RAS was graded according to the duration of tamponade required: gas tamponade = grade1, silicone oil (SO) removed before 6 months = grade2, SO in situ ≥6 months = grade3. Outcomes are compared across the following groups: Asians vs Blacks vs Whites; Young (<40 years old) vs Old (≥40 years old); Males vs Females.
Electronic record search yielded 822 eyes(607 patients). Exclusion: 154 eyes(105 patients) due to incorrect record of diagnosis / surgery; 27 eyes(18 patients) due to inadequate data. For 157 patients who had bilateral surgery, outcomes of a single randomly chosen eye were analysed to maintain sample independence. Final analysis included 484 eyes (484 patients: 12 Asians, 144 Blacks and 345 Whites). Mean±S.D. logMAR BCVA = 1.1±0.9 for Asians, 1.4±0.9 for Blacks, 0.8±0.8 for Whites (P<0.001, Fig 1). For RAS, Asians: 83% grade1, 8.5% grade2, 8.5% grade3. Blacks: 59% grade1, 13% grade2, 28% grade3. Whites: 84.2% grade1, 7.5% grade2, 8.3% grade3 (P<0.001, Fig 2). Mean ± S.D. logMAR BCVA = 1.0±1.0 for Young, 1.1±0.9 for Old (P=0.165). For RAS, Young: 70.8% grade1, 12.5% grade2, 16.7% grade3. Old: 80% grade1, 8% grade2, 12% grade3 (P=0.151). Mean±S.D. logMAR BCVA = 1.0±0.8 for Males, 1.1±1.0 for Females (P=0.152). For RAS, Males: 81% grade1, 7% grade2, 12% grade3. Females: 81% grade1, 7% grade2, 12% grade3 (P=0.146).
Black diabetic patients have worse outcome both functionally (BCVA) and anatomically (RAS) than Asians and Whites, and should be counselled pre-operatively. Age and gender do not show an appreciable effect on outcome.
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