Visual Outcome and Complications of 23 G Versus 20 G Vitrectomy in Cases of Diabetic Vitreous Haemorrhage (original) (raw)
Related papers
Eye, 2012
The study reports 10-year anatomical and visual outcome in patients who underwent pars plana vitrectomy (PPV) for complications due to proliferative diabetic retinopathy (PDR). Methods Retrospective analysis of patients undergoing 20G PPV from January 1999 to May 2010 for tractional retinal detachment (TRD) and non-clearing vitreous hemorrhage (NCVH) secondary to PDR recorded prospectively on an electronic patient record. The primary aim was to study anatomical success and eyes with visual acuity (VA) of r0.3 logMAR at last follow-up. Results There were 346 eyes of 249 patients with mean age of 55.63 years and follow-up of 1.44 years. In all, 95.3% of eyes had a flat retina at final follow-up. Overall 136/346 (39.4%) eyes had final VA of logMAR r0.3 (Snellen 6/12) and 129 (37.3%) had logMAR Z1.0 (Snellen 6/60). In all, 50/181 (27.6%) eyes with TRD and 84/165 (50.9%) with NCVH achieved final VA of r0.3 logMAR (Snellen 6/12). A total of 218 (63.1%) showed Z0.3 logMAR improvement from baseline to last follow-up. Both preoperative VA and final postoperative (post-op) VA (Po0.001) improved significantly with each year from 1999 to 2010. The commonest peroperative complication was iatrogenic retinal tear formation (28.4%). This was a risk factor for the development of post-op retinal detachment, odds ratio: 3.90 (95% confidence interval: 1.91-7.97, P ¼ 0.0002). Silicone oil was used in 5.2% of patients at the primary procedure. In all, 9.2% required removal of non clearing post vitrectomy hemorrhage. Conclusions Outcomes from vitreoretinal surgery for complications of diabetic retinopathy have improved. In addition, the visual outcome after diabetic vitrectomy steadily improved over the 10-year period, which may in part be due to the move to operate on patients with better vision.
Visual Outcome of 25-GAUGE Microincision Vitrectomy Surgery in Diabetic Vitreous Haemorrhage
Pakistan Journal of Medical Sciences, 2015
Objective: To assess the visual outcome and complications of 25-gauge micro incision vitrectomy surgery (MIVS) in diabetic vitreous haemorrhage. Methods: This Quasi Experimental study was conducted at LRBT, Tertiary eye care hospital Karachi, from February 2012 to January 2013. Sixty eyes of sixty patients with uncontrolled type II diabetes mellitus (DM) were included. There were 43 (71.7%) males and 17 (28.3%) females. Age range was 40-60 years. All randomly selected patients underwent 25-gauge sutureless micro incision vitrectomy surgery for diabetic vitreous haemorrhage. Main outcomes measured were best corrected visual acuity (BCVA) assessed with logMAR and post-operative complications. Follow ups were at one day, one week, one month, three months and six months post-operatively. Result: Best corrected visual acuity (BCVA) gradually improved in majority of subjects in each subsequent follow up visit. Preoperative visual acuity was 1.023 ±0.226 logMAR, which was improved after final follow up to 0.457±0.256 and P-value was < 0.001. Five patients developed recurrent vitreous haemorrhage during study period, one patient developed cataract (1.7%), one (1.7%) had ocular hypotony defined as intraocular pressure < 5 mmHg and one (1.7%) developed endophthalmitis. Conclusion: 25-gauge micro incision vitrectomy surgery (MIVS) is an effective sutureless parsplana vitrectomy surgery which has good visual outcome in diabetic vitreous haemorrhage with minimum manageable complications.
Outcomes of vitrectomy in severe complications of proliferative diabetic retinopathy
Ophthalmology Journal, 2017
introduCtion. The aim of our study is to describe the anatomical and functional results of pars plana vitrectomy (PPV) among diabetic patients treated due to tractional retinal detachment (TRD) or non-clearing vitreous haemorrhage (VH). MateriaLs and Methods. A retrospective analysis was made of clinical data of 45 eyes treated with 23G PPV for TRD (17 eyes) or VH (28 eyes). Preoperative and final visual outcomes and postoperative complications were recorded. The mean follow-up period was 12 months. resuLts. The postoperative visual acuity (VA) improved significantly in 60% of eyes, but remained unchanged or was worse in 40%. Improvement of VA was more pronounced in the VH group. PPV was performed with silicone oil tamponade in 66.5%, air tamponade in 29%, and gas tamponade in 4.5%. Postoperative complications included: retinal re-detachment (seven eyes), secondary glaucoma (nine eyes), and recurrent VH (two eyes). ConCLusions. PPV is an effective treatment method of complications of severe proliferative diabetic retinopathy inter alia the TRD and VH. Because surgical management of TRD and VH is demanding, anatomical and functional results are limited by complications.
JAMA ophthalmology, 2015
Patients and clinicians need to accurately assess the risks and benefits of pars plana vitrectomy for proliferative diabetic retinopathy, but clinical trial data may not reflect real-world experience. To prospectively audit the complications of vitrectomy for proliferative diabetic retinopathy and help establish benchmarks. Royal College of Ophthalmologists' National Ophthalmology Database study of 939 eyes of 834 patients undergoing primary vitrectomy for proliferative diabetic retinopathy at 16 different vitreoretinal units in the United Kingdom. Data were obtained for the period from January 2001 to November 2010. Pars plana vitrectomy with or without delamination/segmentation. Descriptions of the primary procedures performed, intraoperative complication rate, and proportion of eyes undergoing further surgery. An exploratory analysis of visual outcome was undertaken, with visual success and visual loss defined as a gain or reduction of 0.3 logMAR or more, respectively (approx...
Outcomes of Vitrectomy for Non-Traumatic Non-Diabetic Vitreous Hemorrhage
2008
To determine the causes of non-traumatic non-diabetic vitreous hemorrhage (NDVH) and to report the visual and anatomical outcomes and complications of vitrectomy for this condition. Method: In a retrospective case series, records of patients who had undergone vitrectomy for non-traumatic NDVH over a ten year period at Labbafinejad Medical Center, Tehran-Iran with at least six months of follow up were reviewed for causes of the condition and outcomes of surgery. Results: From 1993 to 2003, 50 eyes of 49 patients (51% male) with mean age of 62.7±10.3 (range 35-87) years underwent vitrectomy for non-traumatic NDVH. Preoperatively, mean best-corrected visual acuity (BCVA) was 2.36±0.52 LogMAR and relative afferent pupillary defect was positive in 91.1% of the eyes. Mean BCVA increased significantly to 1.38±0.72 LogMAR at six months (P<0.0001). Causes of non-traumatic NDVH included: branch retinal vein occlusion (56%), central retinal vein occlusion (16%), choroidal neovascularization (12%) and posterior vitreous detachment with retinal break, Eales' disease, familial exudative vitreoretinopathy and Terson's syndrome (each in 4%). The most common causes of poor visual outcomes were: macular pigmentary derangement (26%), optic atrophy (16%), severe lens opacity (12%) and epiretinal membrane (8%). Conclusion: Despite the significant increase in VA following vitrectomy, irreversible macular or optic nerve pathology limits significant improvement in central visual acuity in several cases of non-traumatic NDVH. Vascular accidents were the most common cause of this condition.
Journal of Clinical & Experimental Ophthalmology, 2015
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.
2020
Objective: To evaluate the anatomical and visual outcomes of small-gauge vitrectomy in patients with advance diabetic eye diseases (ADED) and the predictive factors for poor visual outcome. Materials and methods: A retrospective study was conducted from 2009 to 2014. Data at baseline, 6 months, and 12 months post-surgery were collected along with baseline demographic data, indications of surgery, systemic associations, visual and anatomical outcome, and postoperative complications. Poor visual outcomewas defined as visual acuity worse than 6/36. Results: A total of 158 eyes from 133 patients were recruited. Mean age was 54.01 ± 11.57 years and mean follow-up was 9.9 ± 3.7 months. Indications for vitrectomy were vitreous haemorrhage (VH, 77 eyes [48.7%]), tractional retinal detachment (TRD) with macular involvement (75 eyes [47.5%]), and other causes in 6 eyes (3.8%). There was visual improvement in 59.3% of patients, 23.6% worsened, and 17.1% stabilized at 12 months post-surgery. Pa...