Abstract
Purpose :
To identify risk and prognostic factors of postoperative neovascular glaucoma (NVG) in eyes which underwent 25-gage vitrectomy for proliferative diabetic retinopathy (PDR) with vitreous hemorrhage (VH).
Methods :
Medical records of 272 eyes of 272 consecutive PDR patients with VH (mean age 56.6 ± 12.7 years) that underwent 25-gage vitrectomy between March 2010 and December 2016 at seven centers were retrospectively reviewed. Preoperative ocular factors (visual acuity, tractional retinal detachment, panretinal photocoagulation [PRP]), general factors (sex, age, diabetic duration, HbA1c, hypertension, anti-coagulant medication, and kidney function), and surgical procedures (preoperative intravitreal anti-vascular endothelial growth factor injection, internal limiting membrane peeling, cataract surgery, iatrogenic retinal tear, and tamponade procedure), and postoperative complications during 12-month follow up were extracted, and were compared between postoperative NVG patients (NVG group; 25 eyes, 9.2%) and non-NVG patients (non-NVG group; 247 eyes).
Results :
NVG group was significantly younger age (50.8 ± 12.3 vs 56.9 ± 13.1; P = 0.012), shorter diabetic duration (9.2 ± 5.9 years vs 13.6 ± 10.1 years; P = 0.039), higher HbA1c level (8.4 ± 2.8 % vs 7.5 ± 1.7%; P = 0.032), and more postoperative VH (48% vs 22.8%; P = 0.0047) than non-NVG group. Logistic regression analysis showed that postoperative VH (P = 0.016), shorter diabetic duration (P = 0.030), and absence of PRP (P = 0.030) were prognostic factors for postoperative NVG.
Conclusions :
These results indicate that younger age, uncontrolled diabetes, lack of PRP, and postoperative VH are risk and/or prognostic factors of postoperative NVG.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.