Jornal de Oftalmologia Clínica e Experimental
Acesso livre

Abstrato

The Surgical Outcomes, Complications and Predictive Surgical Factors of Diabetic Retinopathy Vitrectomy in a Large Asian Tertiary Eye Center

Daniel Shu Wei Ting, Gavin Siew Wei Tan, Wei Yan NG, Ian Yew San Yeo, Laurence Shen Lim, Edmund Yick Mun Wong, Doric Wen Kuan Wong, Sze Guan Ong, Chong Lye Ang and Shu Yen Lee

Purpose: To evaluate the visual, anatomical outcomes, complications and the predictive preoperative and intraoperative factors of pars plana vitrectomy (PPV) for proliferative diabetic retinopathy (PDR) in a large Asian tertiary eye center.
Methods: This is a consecutive retrospective review of 106 eyes that underwent PPV for PDR complications in 2013. The functional success was defined as visual acuity of 20/200 or better while the anatomical success was defined as 360° flat retina without endo-tamponade at one year.
Results: The overall functional and anatomical success was 77.4% and 94.3%, respectively. The common complications were iatrogenic break (14.2%), raised intraocular pressure (IOP) (13.2%), cataract (13.2%) and recurrent vitreous hemorrhage (12.3%). The use of intraoperative triamcinolone (OR: 0.36, p=0.04) and silicone oil (OR: 0.08, p<0.001) were associated with poorer visual success. The iatrogenic breaks occurred more often in 20G PPV than 23G PPV (OR: 5.89, p=0.02) whereas intraoperative silicone oil were associated with postoperative raised IOP (OR: 3.71, p=0.04). The use of bevacizumab was not found to reduce recurrent vitreous hemorrhage (OR: 0.53, 95%CI: 0.11-2.53, p=0.43).
Conclusions: In the era of small gauge vitrectomy, the visual, anatomical outcomes and complication rates of PPV for PDR patients in Singapore had improved significantly, as compared to the Diabetic Retinopathy Vitrectomy Study.