Helbig H, Kellner U, Bornfeld N, Foerster M H
Department of Ophthalmology, Universitätsklinikum Benjamin Franklin, Freie Universität Berlin, Germany.
Br J Ophthalmol. 1996 Jul;80(7):640-3. doi: 10.1136/bjo.80.7.640.
Patients with advanced diabetic eye disease are commonly in poor general health. In addition to the ocular status, life expectancy is an important factor in the decision whether and how to perform vitreous surgery. The present study investigates mortality and risk factors for survival in diabetic patients following vitrectomy.
The follow up of 332 consecutive patients who underwent vitrectomy for complications of diabetic retinopathy between 1990 and 1994 was studied retrospectively. Survival and risk factors for survival were analysed using the Kaplan-Meier life table method and for multivariate analysis the Cox proportional hazard model.
The 5 year survival rate was 68%. Absence of heart disease was the most important predicting factor for survival. Fifty per cent of the patients with heart disease had died within 3.5 years. Patients without heart disease had a 5 year survival rate of 90%. Other significant, independent risk factors were age and presence of nephropathy.
In diabetic patients undergoing vitrectomy the presence of heart disease indicates a poor prognosis for survival. This should be taken into consideration for indications and strategies in cases of vitrectomy.
晚期糖尿病眼病患者的整体健康状况通常较差。除眼部状况外，预期寿命是决定是否以及如何进行玻璃体手术的一个重要因素。本研究调查糖尿病患者玻璃体切除术后的死亡率及生存危险因素。
对1990年至1994年间因糖尿病视网膜病变并发症接受玻璃体切除术的332例连续患者进行回顾性研究。采用Kaplan-Meier生存表法分析生存率及生存危险因素，多因素分析采用Cox比例风险模型。
5年生存率为68%。无心脏病是生存的最重要预测因素。50%的心脏病患者在3.5年内死亡。无心脏病患者的5年生存率为90%。其他显著的独立危险因素为年龄和肾病的存在。
在接受玻璃体切除术的糖尿病患者中，心脏病的存在表明生存预后较差。在玻璃体切除病例的适应证和治疗策略中应考虑这一点。
