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H. Hashim, V, A. Roslin Azni, N. Nor Farzia, K. Lim; Primary Diabetic Vitrectomy in Selayang Hospital. Invest. Ophthalmol. Vis. Sci. 2007;48(13):2209.
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To analyse results of primary vitrectomy in diabetic eyes and to determine the factors that may contribute to poor visual outcome in Selayang Hospital.
One hundred and sixteen diabetic eyes who underwent primary vitrectomy in Selayang Hospital from January to December 2005 were analysed retrospectively.
One hundred and sixteen diabetic eyes consisted of 41 (35.3%) female and 75 (64.7%) male. Mean age 50.3 ± 10.9 years, median age 52 years. Forty-seven (40.5%) were Malay, 42 (36.2%) Chinese and 26 (22.4%) were Indian. After mean follow up of one year, visual acuity (VA) improved in 70 eyes (60.3%), sustained in 14 eyes (12.2%) and worsened in 32 eyes (27.5%). Fifty-nine eyes (50.9%) achieved VA of 6/60 or better after vitrectomy compared to 25 eyes (21.7%) before surgery. Median VA has significantly improved from counting finger at two feet (CF-2) to 6/60 (p< 0.01). Univariate analysis showed that iris neovascularisation postoperatively and combined type of retinal detachment (RD) had significantly worsened visual outcome. Multiple logistic regressions showed that postvitrectomy iris neovascularisation was the strongest predictor towards poor visual outcome after primary diabetic vitrectomy. In the presence of post-vitrectomy iris neovascularisation, the chance of obtaining VA of poor than 6/60 is almost 100%. Age older than 50 years old, VA worse than 6/60 preoperatively, presence of pre-vitrectomy iris neovascularisation were not associated with poor visual outcome in this study as were reported by other studies.
1. Primary diabetic vitrectomy significantly improved visual outcome in our setting.2. Rubeosis post-vitrectomy is the strongest predictor for poor visual outcome.3. Combined RD is associated with poor visual outcome post primary diabetic vitrectomy.
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