Literature DB >> 23317651

Postoperative vitreous hemorrhage after diabetic 23-gauge pars plana vitrectomy.

Mohammed K Khuthaila1, Jason Hsu, Allen Chiang, Francis Char DeCroos, Eugene A Milder, Vikram Setlur, Sunir J Garg, Marc J Spirn.   

Abstract

PURPOSE: To report the frequency of postoperative vitreous hemorrhage (VH) in eyes that underwent primary 23-gauge pars plana vitrectomy (PPV) for nonclearing VH resulting from proliferative diabetic retinopathy, as well as associated risk factors.
DESIGN: Retrospective, consecutive, interventional case series.
SETTING: Institutional (Retina Service of Wills Eye Institute). STUDY POPULATION: One hundred seventy-three eyes of 157 patients. INTERVENTION: Twenty-three-gauge PPV for nonclearing diabetic VH. MAIN OUTCOME MEASURES: Percentage of eyes in which postoperative VH developed, categorized as early, delayed, or severe persistent, as well as percentage requiring reoperation.
RESULTS: During a mean follow-up of 32 weeks, 56 (32%) of 173 eyes demonstrated postoperative VH, categorized as early (8 eyes; 5%), delayed (13 eyes; 8%), or severe persistent (35 eyes; 20%). Twenty-two (13%) of 173 eyes required reoperation: 4 (50%) of 8 in the early group, 8 (62%) of 13 in the delayed group, and 10 (29%) of 35 in the severe persistent group. Mean preoperative logarithm of the minimum angle of resolution visual acuity was 1.5 (Snellen equivalent, approximately 20/600); mean postoperative VA was 0.65 (Snellen equivalent, approximately 20/90), a gain of 0.85 (P < .0001). Thirty-four (27%) of 127 eyes with complete scatter photocoagulation before undergoing PPV compared with 22 (48%) of 46 eyes with incomplete scatter photocoagulation before undergoing PPV demonstrated postoperative VH (P = .002). Other factors associated with postoperative VH included younger age (P = .022) and phakia (P = .036).
CONCLUSIONS: Postoperative VH was not uncommon after initial 23-gauge PPV for diabetic VH and was associated with incomplete scatter photocoagulation, younger age, and phakia before PPV. However, only a minority of patients required reoperation.
Copyright © 2013 Elsevier Inc. All rights reserved.

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Year:  2013        PMID: 23317651     DOI: 10.1016/j.ajo.2012.11.004

Source DB:  PubMed          Journal:  Am J Ophthalmol        ISSN: 0002-9394            Impact factor:   5.258


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