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增殖性糖尿病视网膜病变并发症的玻璃体切割再手术

Pars Plana Vitrectomy Reoperations for Complications of Proliferative Diabetic Retinopathy.

作者信息

Al-Khersan Hasenin, Venincasa Michael J, Kloosterboer Amy, Sridhar Jayanth, Smiddy William E, Townsend Justin H, Flynn Harry W

机构信息

Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA.

出版信息

Clin Ophthalmol. 2020 Jun 10;14:1559-1563. doi: 10.2147/OPTH.S252285. eCollection 2020.

DOI:10.2147/OPTH.S252285
PMID:32606570
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7293964/
Abstract

OBJECTIVE

To report visual acuity in patients undergoing pars plana vitrectomy (PPV) reoperations for complications of proliferative diabetic retinopathy (PDR).

DESIGN

Retrospective case series.

SUBJECTS

Diabetic patients undergoing reoperation with PPV between 2015 and 2018 at a university referral center.

METHODS

Patient charts were reviewed for indication for initial and repeat PPV, baseline clinical characteristics including gender, age, and lens status, and pre- and post-operative best-corrected visual acuity.

MAIN OUTCOME MEASURES

Best-corrected visual acuity at last follow-up.

RESULTS

Of 538 eyes (409 patients) undergoing a PPV for diabetic retinopathy, 153 (28.4%) eyes had reoperation. Among the 130 eyes (119 patients) that met the inclusion criteria, 55 eyes (50 patients) underwent reoperation for complications of PDR, defined as non-clearing vitreous hemorrhage (NCVH) and/or tractional retinal detachment (TRD). Within this subgroup of 55 eyes, 19 (34.5%) eyes had an indication for the first surgery of NCVH. Fourteen (73.7%) of these NCVH eyes achieved a visual acuity of 20/80 or better. When the indication for the first surgery was TRD (33 eyes, 60%), 8 (24.2%) eyes achieved this same outcome (p=0.0011).

CONCLUSION

Approximately one of every four eyes treated with PPV for PDR will undergo repeat PPV during follow-up. VA outcomes after the repeat PPV were variable, with NCVH cases achieving better outcomes compared to TRD.

摘要

目的

报告因增殖性糖尿病视网膜病变(PDR)并发症而接受玻璃体切割术(PPV)再次手术患者的视力情况。

设计

回顾性病例系列研究。

研究对象

2015年至2018年在一所大学转诊中心接受PPV再次手术的糖尿病患者。

方法

查阅患者病历,了解初次和再次PPV的指征、包括性别、年龄和晶状体状态在内的基线临床特征,以及术前和术后最佳矫正视力。

主要观察指标

最后一次随访时的最佳矫正视力。

结果

在538只(409例患者)因糖尿病视网膜病变接受PPV手术的眼中,153只(28.4%)进行了再次手术。在符合纳入标准的130只眼(119例患者)中,55只眼(50例患者)因PDR并发症接受了再次手术,这些并发症定义为玻璃体出血不吸收(NCVH)和/或牵拉性视网膜脱离(TRD)。在这55只眼的亚组中,19只眼(34.5%)初次手术指征为NCVH。这些NCVH眼中有14只(73.7%)术后视力达到20/80或更好。当初次手术指征为TRD时(33只眼,60%),8只眼(24.2%)达到了相同的视力结果(p=0.0011)。

结论

接受PPV治疗PDR的患者中,约四分之一的眼在随访期间将接受再次PPV。再次PPV后的视力结果各不相同,NCVH病例的结果优于TRD。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e26d/7293964/afb766a47dc1/OPTH-14-1559-g0002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e26d/7293964/b44ef707c246/OPTH-14-1559-g0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e26d/7293964/afb766a47dc1/OPTH-14-1559-g0002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e26d/7293964/b44ef707c246/OPTH-14-1559-g0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e26d/7293964/afb766a47dc1/OPTH-14-1559-g0002.jpg

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