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Ferdinand Rodriguez, Samuel Kim, Alexander Melamud; An Analysis of Visual Outcomes in Patients With and Without Postoperative Vitreous Hemorrhage After Diabetic Vitrectomy. Invest. Ophthalmol. Vis. Sci. 2017;58(8):5040.
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© ARVO (1962-2015); The Authors (2016-present)
Postoperative Vitreous Hemorrhage (VH) is a common complication after diabetic vitrectomy. In order to determine the effect of immediate postoperative VH on visual recovery we hypothesized in this study that final visual acuity (VA) is superior in the long run in patients that do not rebleed in the immediate post-op period.
Medical records were reviewed for all patients who underwent a PPV with pan-retinal photocoagulation and/or complex retinal detachment (RD) repair for non-clearing diabetic VH or tractional RD at the Retina Group of Washington between 01/2010-06/2015. Patients had a minimum of 6 months post-op follow-up. VA was measured pre-op, and final VA was measured at their last visit between 6-18 months after surgery. Our first group included patients who did not experience post-op VH and the second group had post-op VH within 3 months of surgery. Patients who had prior vitrectomy or silicone oil were excluded from the study. Paired t-test was used to analyze the association between pre-op VA and post-op VA in each group. A welch two sample t-test was used to compare final VA in the two groups and the mean change in VA between the groups.
431 eyes were included in the study, 205 eyes had post-op VH, while 226 did not have post-op VH. The average pre-op logMAR in the non-VH group was 1.506; the average final logMAR post-op in non-VH group was 0.669 (p<0.001). The VH group average pre-op logMAR and average final logMAR was 1.707 and 0.8253, respectively (p<0.001). When comparing final post-op logMAR between the non-VH group and the re-bleeder group the difference was of borderline significance (p=0.07). The mean change in logMAR from pre-op to post-op between the groups was not statistically significant (p=0.707).
Final VA was significantly improved from pre-op VA in both groups. A trend was found towards better final VA in the non rebleeders, however this was found to be of borderline significance. Comparing the mean change in VA before and after surgery between both groups we found no statistically significant difference. Although our results are not consistent with our hypothesis, the fact that there is no statistically significant difference in the change in VA between both groups may be helpful when counseling patients who rebleed after diabetic vitrectomy. Nonetheless, further studies are needed to corroborate our findings.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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