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M. R. del Cid, N. Trichopoulos; Factors Associated With Repeat Vitreous Hemorrhage Following Vitrectomy for Diabetic Vitreous Hemorrhage. Invest. Ophthalmol. Vis. Sci. 2009;50(13):6074.
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To explore any clinical or peri-operative characteristics that may be associated with repeat vitreous hemorrhage (VH) following uncomplicated vitrectomy performed for diabetic VH.
A retrospective chart review was performed on patients receiving vitrectomy for diabetic VH at the University of Texas Health Science Center in San Antonio, Texas between 2005-2008. All patients had no previous history of vitrectomy surgery in the operative eye. Patients requiring a membrane peel or repair of a retinal detachment at the time of surgery were excluded from the study. Forty-three patients (51 eyes) were included in the study and were divided into two groups: a repeat VH (RVH) group and a non-repeat VH (NRVH) group. Variables of interest abstracted from the medical records included duration of VH, time to repeat VH, pre and post-operative vision, any previous interventions to the operative eye including PRP (partial vs complete), status of the fellow eye, presence or absence of neovascularization of the iris, phakic status, type of medication for blood sugar control, type of diabetes, use of anticoagulants including aspirin, co-morbidities including hypertension, neuropathy or coronary artery disease, and level of peri-operative blood glucose and blood pressure control (well vs poorly controlled). T-test and Fisher's exact test were utilized for data analysis.
Sixteen patients (21 eyes) developed repeat VH while 27 patients (30 eyes) did not. Mean follow up time was 24 and 19 months for the RVH and NRVH groups respectively. The mean duration of the initial VH prior to vitrectomy surgery was 10 months for both groups. Time to repeat VH averaged 214 days. Both groups were evenly matched with regards to pre and post-operative vision and co-morbidities. A significantly higher proportion of subjects in the RVH group were on anticoagulation therapy at the time of surgery (p=0.048) and had a previous history of full PRP to the operative eye (p=0.003) when compared to the NRVH group. In addition, most patients in the RVH group required diabetic vitrectomy to the fellow eye either before or after vitrectomy to the operative eye when compared to the NRVH group (p=0.003).
Repeat vitreous hemorrhage occurred substantially more frequently in patients using anticoagulants or had previous history of full PRP to the operative eye or underwent vitrectomy for diabetic retinopathy in the fellow eye.
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