Surgical Outcome and Postoperative Complications of Vitrectomy for Diabetic Retinopathy

Jung, Bo Young; Shin, Jae Pil; Kim, Si Yeol

Abstract

PURPOSE: The surgical outcome of diabetic vitrectomy, prognostic factors influential to development of postoperative complications and possible risk factors of postoperative neovascular glaucoma which is main cause of blindness were evaluated.
METHODS
The medical records of 56 eyes in 51 patients who underwent vitrectomy for proliferative diabetic retinopathy were reviewed.
RESULTS
Anatomical success was achieved in 50 eyes (89%) and vision better than 5/200 in 39 eyes (70%) of 56 eyes that had undergone vitrectomy due to diabetic retinopahty. Statistically significant improvement of vision was obtained among the patients who had preoperative visual acuity of 5/200 or better (p<0.05). Postoperative complication such as neovascular glaucoma proved to be detrimental to visual outcome. The causes of poor visual outcome included neovascular glaucoma, optic atrophy, cataract, macular edema, subretinal hemorrhage, macular subretinal fibrosis, and vitreous hemorrhage. Neovascular glaucoma occurred in 5 eyes among the total 56 eyes (9%). There was no statistically different result in the incidence of neovascular glaucoma according to preoperative panretinal photocoagulation, intraoperative cataract extraction, postoperative retinal detachment, intraocular gas or oil injection, duration of diabetes, control of blood sugar and presence of diabetic nephropathy.
CONCLUSIONS
The visual prognosis of diabetic vitrectomy is related with preoperative visual acuity. As neovasular glaucoma is detrimental to visual outcome, it is important to find postoperative neovascularizaton on iris as soon as possible and effective treatment is also important.