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S. Kim, J.-H. Yi, S. Byeon, H. Koh, S. Lee, O. Kwon; Shorter Axial Length as a Poor Prognostic Factor for Outcomes of Vitrectomy in Diabetic Eyes. Invest. Ophthalmol. Vis. Sci. 2007;48(13):1405. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate if shorter axial length (AXL) correlates with the outcome of vitreous surgery in patients with proliferative diabetic retinopathy (PDR).
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).
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)
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)
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