Abstract
Abstract: :
Purpose: The aim of this study was to evaluate changes of blood–aqueous barrier (BAB) permeability in eyes with proliferative diabetic retinopathy treated with pars plana vitrectomy. The influence of silicone oil administered into the eyeball to the barrier permeability was evaluated, too. Methods: We examined 39 consecutive patients scheduled for pars plana vitrectomy due to proliferative diabetic retinopathy. Patients were divided into 2 groups according to the application of silicone oil: I (25 eyes) – patients treated with vitrectomy without the oil, II (14 eyes) – patients treated with vitrectomy with the oil. Mean age in the groups was 54 and 48,3 years, respectively. The control group consisted of 50 eyes of 39 healthy individuals. The blood–aqueous barrier permeability was measured quantitatively with the use of laser flare meter (KOWA SM–500) before and 24 h, 5 days and 1 month after the operation. Results: In all patients aqueous flare values taken before operation were significantly higher compared to the control (p<0,05). Surgical procedure resulted in the significant increase of the values compared to the preoperative measurements. The highest values were noticed 24 hours after operation (p0,05). In group II patients treated with vitrectomy and silicone oil had significantly higher aqueous flare values before and after the operation when compared to those operated without oil. But the course of tyndalometric curve was similar in both groups. In addition in group II diabetic retinopathy was far more advanced than in the diabetic patients treated without the oil. Conclusions: 1. Blood–aqueous barrier permeability increases significantly shortly after pars plana vitrectomy. 2. In the proliferative diabetic retinopathy blood–aqueous barrier breakdown corresponds to the severity of pathological changes. Operation had significant influence on BAB up to 5th day. 3. Silicone oil application has no significant influence on the blood–aqueous barrier breakdown connected with surgical procedure but differences noticed between the groups may be related to more advanced diabetic retinopathy in patients treated with vitrectomy and silicone oil.
Keywords: vitreoretinal surgery • diabetic retinopathy • aqueous