Abstract
Purpose::
To evaluate if shorter axial length (AXL) correlates with the outcome of vitreous surgery in patients with proliferative diabetic retinopathy (PDR).
Methods::
We retrospectively reviewed medical records of 162 eyes of 120 patients who underwent diabetic vitrectomies from May 2000 to December 2005 by a single surgeon (SSK), and were evaluated at least 3 months postoperatively. Preoperative data included: ocular AXL for intraocular lens power calculation, visual acuity (VA), combined systemic diseases, and preoperative scattered laser treatment (PRP). Postoperative data included: confirmed diagnoses (POSTOP DX), frequency of silicone oil tamponade (SOT), and complications. Outcome measures included: anatomical success, improvement of vision, and best corrected final visual acuity (BCFVA). The patient were stratified into two groups, according to shorter or longer axial length (SAXL ≤22.5mm - 48 eyes, LAXL >22.5mm - 114 eyes).
Results::
Overall, 119 eyes (73.4%) showed improvement of BCFVA, and 12 eyes (7.4%) were failed anatomically (became NLP) after surgery. SAXL showed poorer BCFVA (≤0.1 p=0.0026, 0.2≤ p=0.0032), and higher frequency of SOT (p=0.0007) than LAXL. 48 eyes (29.6%) of both subgroups had vitreous hemorrhage without tractional retinal detachment, but 5 eyes (10.4%) were included in the SAXL subgroup; 43 eyes (89.6%) of SAXL did not have PVD. Logistic regression analysis yielded that SAXL is a significant risk factor for BCFVA worse than 0.2 (ODD Ratio 1.83, 1.19-2.81, 95% CI at 3 month after surgeries , OR 1.56, 1.06-2.30, 95% CI at final visit) and BCFVA worse than 0.1 at 3 month after surgeries (OR 1.632, 1.010-2.636, 95% CI). SAXL was also risk factor for anatomical failure(OR 2.42, 1.11-5.25, 95% CI), and SOT(OR 2.21, 1.39-3.52, 95% CI)
Conclusions::
The results of this study suggest that shorter axial length is a risk factor for poorer outcome after vitreous surgery in PDR, and it is related to the low incidence of PVD in short eyes.(p<0.0001)
Keywords: diabetic retinopathy • vitreoretinal surgery • proliferative vitreoretinopathy