Pronostic factors and complications of vitrectomy in patients with advanced diabetic retinopathy

Abstract

Purpose The aim of this study is to present the results of pars plana vitrectomy in patients with advanced disease and to identify preoperative risk factors and postoperative visual outcome. Methods The study was carried out at the University Hospital in Valladolid (Spain) with data from patients throughout two years. Results Retrospective chart review of patients who underwent posterior plas plana vitrectomy (PPV) during 2010‐2011 for non‐clearing vitreous haemorrhage (NCVH), tractional retinal detachment (TDR) or diabetic edema with vitreomacular traction (TME) and followed for at least 6 months.The primary outcome measure was the best corrected visual acuity (BCVA) at the end of the follow‐up period and its correlation with preoperative risk factors.The secondary outcomes were postoperative complications and the influence of the status of the external retina in the ocular coherence tomography (OCT). 58 patients underwent PPV for advanced retinal disease. NCVH was the most frequent surgical indication in 32 patients and 21 of them had gone through laser previously. Mean preoparative BCVA was 1.96 ± 1.13 logarithm of minimum angle of resolution (logMAR) units and it improved.TDR was the indication in 10 patients. Only 50% of them had laser and all of them suffered from long term disease. There was not significant improvement in the BCVA and 3 patients developed neovascular glaucoma. Ind Conclusion Preoperative BCVA, long term disease, the lack of laser treatment and the external retina seem to be some of the most important risk factors in these patients.