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P. Gohel, N. Mandava, J. Olson; Vitreous Hemorrhage after Vitrectomy for Proliferative Diabetic Retinopathy . Invest. Ophthalmol. Vis. Sci. 2006;47(13):5266.
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To identify risk factors and incidence of post–vitrectomy hemorrhage requiring repeat vitrectomy as well as visual outcomes in eyes that had undergone pars plana vitrectomy for complications of diabetic retinopathy.
A retrospective review of 75 consecutive pars plana vitrectomies performed by 2 surgeons with at least 6 month follow–up during a 7 year period of eyes requiring vitrectomy for diabetic vitreous hemorrhage.
Seventy–five eyes were reviewed, 15 of which required repeat vitrectomy for post–vitrectomy vitreous hemorrhage. Of the 60 eyes requiring only 1 vitrectomy, the mean initial visual acuity was 20/1702. These eyes had an improvement in visual acuity with a mean final visual acuity of 20/126 (p<0.00001). Of the 15 cases requiring 2 or more vitrectomies, visual acuity improved from 20/1321 to 20/302. This difference trended toward improvement, however was not statistically significant (p=0.054). Between the two groups, there was not a statistical difference in initial visual acuity (p=0.57). However, eyes requiring repeat vitrectomy had a worse final visual acuity than those requiring only 1 vitrectomy (p=0.01). Eyes with a crystalline lens required repeat vitrectomy 26.4% of the time, whereas only 4.6% of aphakic/pseudophakic eyes required repeat vitrectomy. This difference was statistically different (p=0.03).
Eyes requiring repeat vitrectomy for post vitrectomy vitreous hemorrhage had a worse final visual outcome than eyes requiring only 1 vitrectomy. Phakic eyes are at increased risk of recurrent vitreous hemorrhage requiring vitrectomy.
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