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慢性肾衰竭合并增殖性糖尿病视网膜病变患者血液透析与玻璃体切割术手术结局的相关性:一项回顾性分析

Association between hemodialysis and surgical outcomes of pars plana vitrectomy in patients with chronic renal failure and proliferative diabetic retinopathy: a retrospective analysis.

作者信息

Wang Yalin, Hao Miao, Kong Xianxian, Zhao Suzhen, Ma Shengnan, Zhou Weiyan

机构信息

Department of Ophthalmology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250000, Shandong Province, China.

Ningbo Aier Guangming Eye Hospital, 8 Huancheng West Road, Ningbo, 315020, China.

出版信息

Eur J Med Res. 2025 May 31;30(1):432. doi: 10.1186/s40001-025-02725-x.

Abstract

BACKGROUND

To investigate the association between Hemodialysis (HD) and postoperative outcomes in patients diagnosed with chronic renal failure (CRF) who underwent pars plana vitrectomy (PPV) for proliferative diabetic retinopathy (PDR).

METHODS

This was a retrospective study. Fifty-three eyes were divided into HD (25 eyes) and non-HD (28 eyes) groups. Follow-up assessments were performed preoperatively and at 1 week, 2 weeks, 1 month, 2 months, 4 months, 8 months and 12 months postoperatively. Independent risk factors affecting visual recovery following PPV were also determined.

RESULTS

The HD group exhibited significantly lower intraocular pressure (IOP) from 1 week to 2 months postoperatively compared to the non-HD group (P < 0.05). While non-HD patients had better preoperative best-corrected visual acuity (BCVA), HD patients achieved superior BCVA at 2 months (P < 0.05), with higher rates of visual improvement at 12 months (84.00% vs. 78.57%). Prolonged diabetes duration and elevated total cholesterol levels negatively correlated with postoperative VA prognosis (P < 0.05). The preoperative eye conditions, lens status, postoperative complications were not significantly different (P > 0.05).

CONCLUSIONS

Preoperative HD is associated with short-term reductions in IOP and improvements in BCVA after PPV, with long-term data correlating HD to better visual acuity outcomes. However, unmeasured confounders may influence these results. Prolonged diabetes duration and elevated total cholesterol levels also appear associated with slower visual recovery, warranting further validation.

摘要

背景

探讨慢性肾衰竭(CRF)患者因增殖性糖尿病视网膜病变(PDR)接受玻璃体切割术(PPV)后,血液透析(HD)与术后预后之间的关联。

方法

这是一项回顾性研究。53只眼被分为HD组(25只眼)和非HD组(28只眼)。在术前以及术后1周、2周、1个月、2个月、4个月、8个月和12个月进行随访评估。还确定了影响PPV后视力恢复的独立危险因素。

结果

与非HD组相比,HD组术后1周至2个月眼压(IOP)显著降低(P < 0.05)。虽然非HD患者术前最佳矫正视力(BCVA)更好,但HD患者在术后2个月时BCVA更佳(P < 0.05),在术后12个月时视力改善率更高(84.00%对78.57%)。糖尿病病程延长和总胆固醇水平升高与术后视力预后呈负相关(P < 0.05)。术前眼部情况、晶状体状态、术后并发症无显著差异(P > 0.05)。

结论

术前HD与PPV术后眼压短期降低及BCVA改善相关,长期数据显示HD与更好的视力结果相关。然而,未测量的混杂因素可能影响这些结果。糖尿病病程延长和总胆固醇水平升高似乎也与视力恢复较慢有关,有待进一步验证。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8c14/12125865/31ae37235afd/40001_2025_2725_Fig1_HTML.jpg

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