Abstract
Purpose :
To evaluate visual and anatomical outcomes and prognostic factors of pars plana vitrectomy (PPV) in eyes with proliferative diabetic retinopathy and light perception vision at UCLA affiliated county hospitals from April 2018 to April 2022.
Methods :
In this retrospective chart review study, medical records of patients who underwent pars plana vitrectomy for diabetic retinopathy and their visual acuity was light perception were reviewed. Exclusion criteria was vitrectomy for indications other than diabetic retinopathy and loss of follow up. Preoperative, intraoperative and postoperative characteristics were extracted.
Results :
Fifty eyes from 50 patients included. Average age was 51.42 (±9.09) years old, 46% were female.16 eyes had tractional retinal detachment (TRD) and 16 eyes had rhegmatogenous retinal detachment (RRD). Preop characteristics included:
Wait time until surgery: 42 (45.91)
Visual acuity on sign up (logMAR): 2.7
IOP: 17.65 (10.97)
Vitreous hemorrhage (yes, %): 45 (90%)
History of Avastin injectin excluding preop (yes, %): 19 (38%)
Preop Avastin (yes, %): 29 (58%)
Prior PRP (yes, %): 19 (38%)
Mac status (on, %): 34 (68%)
NVG Glaucoma (yes, %): 4 (8%)
Intraoperative characteristics included:
25 Gauge Vitrectomy (Yes, %): 32 (64%)
CEIOL Combined (Yes, %): 10 (20%)
Length of surgery (mean, SD): 2.1 (1.18) hours
Air fluid exchange (yes, %): 39 (78%)
Silicon oil tamponade (yes, %): 13 (26% )
Retinectomy (yes, %): 2 (4%)
PFL use (yes, %): 8 (16%)
Tamponade used (yes, %): 6 (12% C3F8, SF6 6(12%), Air 6(12%)
Postoperative characteristics included:
Post operative month (POM) 1 VA (LogMAR, SD): 1.99 (0.78) {20/2000}; p<0.0001
POM6 VA: 1.70 (0.95) {20/1000}; p<0.0001
Final VA : 1.69 (1.02) {20/1000}
POM1 IOP (mean, SD): 18.02 (9.59)
Final IOP (mean, SD): 16.37 (6.49)
VH post-op (yes, %): 15 (38.5%)
PRP post-op (yes, %): 2 (5.1 %)
Avastin post-op (yes, %): 10 (25.6%)
Mac off post-op (yes, %): 6 (15.4%)
POM 6 4 NLP + 5 LP = 9 (24.3%)
Factors associated with final retinal reattachment are shown in table 1
Conclusions :
Vitrectomy significantly improves vision among PDR patients within 6 months. However, 25% of patients did not have visual improvements. Length of surgery and the use of silicone oil which posed the biggest risk factors for worse visual outcome, number of vitrectomies, status of macula pre-operatively, and the diagnoses of PVR and combined TRD/RRD were significant risk factors for retinal reattachment.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.