Diabetics in Population of Patients Treated by Pars Plana Vitrectomy
Bezdéšová-Bohunická N., Skorkovská Š., Synek S.,Kaňovský R., Mašková Z., Synková M.
Klinika nemocí očních a optometrie LF MU a FN u sv. Anny, Brno, přednosta doc. MUDr. Svatopluk Synek, CSc. |
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Summary:
The purpose of this study is to evaluate visual and anatomic outcomes following
pars plana vitrectomy (PPV) for complications of diabetic retinopathy (DR),
and to assess risk factors that might influence the visual outcome after
successful PPV.
The medical records of 35 diabetic patients of both types 1 and 2 of diabetes,
who underwent vitrectomy for complications of proliferative diabetic
retinopathy (PDR) between 2004 and 2005, were analyzed retrospectively.
Certain preoperative systemic and ophthalmic variables, intraoperative
variables and postoperative complications with negative influence on visual
outcome after PPV were recorded. The postoperative follow-up time was 6
months. The collected data as well as visual outcomes after PPV were
statistically analyzed.
Statistically significant visual improvement was achieved in 51.4 % of the
patients; visual acuity (VA) deteriorated in 25.7 % of the patients and remained
unchanged in 22.9 % of the patients. Preoperative median of VA was 0.0167,
changed to 0.1 postoperatively and remained stable on 0.1 level during the 6
months follow-up. VA ≥ 0.1 was achieved in 60 % of the patients 6 months after
PPV.
Some of the followed variables associated with deteriorated or unchanged
postoperative VA can be considered as risk factors of an unfavorable prognosis.
Evaluated risk factors include preoperative VA worse than 0.1, presence of
systemic complications of DM accompanying ocular complications,
postoperative occurrence of iris neovascularization and neovascular glaucoma.
In conclusion, anatomically successful PPV in diabetic patients is not always
followed by an improvement of VA. The optimal timing of vitrectomy is very
important not only in order to obtain good visual acuity but also to maintain
good visual function for long time. We suppose that an adequate control of DM,
sufficient screening for DR and timely laser intervention of DR might decrease
the progression of DR and onset of sight threatening complications of PDR as
well as decrease the prevalence of blindness at diabetic patients in the future.
Key words:
diabetes, proliferative diabetic retinopathy, pars plana vitrectomy
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