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N. V. Nayak, D. P. Shah, M. Pham, M. A. Zarbin, N. Bhagat; Anatomic and Functional Outcome in Diabetic Eyes Undergoing Pars Plana Vitrectomy for Vitreous Hemorrhage. Invest. Ophthalmol. Vis. Sci. 2010;51(13):5076.
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© ARVO (1962-2015); The Authors (2016-present)
To assess risk factors for poor functional and anatomic outcome in diabetic eyes undergoing pars plana vitrectomy (PPV) for vitreous hemorrhage (VH).
Retrospective chart review of all diabetic patients who underwent PPV for VH without a retinal detachment by two surgeons, NB and MZ, between March 2001 and July 2006. Patient variables assessed included demographics, pre-operative characteristics, other intraoperative procedures, pre- and post-operative visual acuity (VA), and recurrence of VH. Using univariate analysis, t-tests, Chi-square, and Fisher’s Exact test, these variables were assessed for their impact on poor visual outcome (< 20/200) and recurrence of VH.
Forty-two surgical eyes (42 subjects) met selection criteria. 24 subjects (57%) were male. The mean age was 56 years (range of 27-85). The mean pre-operative and post-operative logMAR VA was 2.9 and 1.3, respectively. The mean number of PPVs necessary for clearing of VH was 1.02. Seventeen eyes (40%) underwent tamponade - air (11), C3F8 (1), SF6 (3), and silicone oil (2). Of the sixteen eyes (38%) that had poor visual outcome, 8 had a recurrent VH, 3 had concurrent PPL, and 2 had concurrent IOL placement. Concurrent IOL placement, concurrent PPL, and post-operative fibrinoid syndrome were factors associated with poor visual outcome (chi-square, P< 0.05). In the eighteen eyes (43%) that had a recurrent VH, pre-existing conditions included rubeosis (5) and cataracts (15). Mean logMAR VA of this group was 1.3 and fourteen had prior PRP sessions. One eye underwent second PPV due to recurrent VH.
Pre-operative and intra-operative characteristics may play a significant role in recurrence of post-operative VH and should be further evaluated. These factors should be taken into consideration when discussing functional and anatomic outcome in such patients.
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