Abstract
Purpose: :
To compare the visual outcome following vitrectomy for proliferative diabetic retinopathy between young and middle–aged patients.
Methods: :
Subjects were 154 consecutive eyes of 114 patients (age 52.8 ± 13.9 years, mean ± SD) undergoing primary pars plana vitrectomy for proliferative diabetic retinopathy who were followed up for at least 6 months postoperatively. There were of 20 patients (29 eyes) who were 40 years or younger (younger group) and 94 patients (125 eyes) older than 40 years (older group). We retrospectively reviewed preoperative best corrected visual acuity, preoperative HbA1c, degree of proliferative diabetic retinopathy, final best corrected visual acuity, presence of neovascular glaucoma, and postoperative complications.
Results: :
The HbA1c level was significantly higher in the younger group than in the older group (9.5 ± 3.3 % vs. 8.0 ± 2.2 %, p<0.05). The rate of patients whose visual acuity improved by 2 lines or more was 81% in the older group vs. 66 % in the younger group (p<0.05). In the older group, 22 % attained final visual acuity of 32/40 or better, while 38% in the younger group obtained the same level (p<0.05). The incidence of postoperative complication (reproliferation, neovascular glaucoma, or vitreous hemorrhage) did not differ between groups. Previous history of panretinal photocoagulation and severe proliferative diabetic retinopathy were the risk factors of poor visual prognosis in the younger group.
Conclusions: :
Visual prognosis and operative outcome after vitrectomy in younger diabetic patients may be different from those in older diabetic patients, probably due to the different background characteristics of the disease.
Keywords: diabetic retinopathy • proliferative vitreoretinopathy • vitreoretinal surgery