Abstract:AIM: To investigate the timing and efficacy of vitrectomy for patients with vitreous hemorrhage(VH)due to proliferative diabetic retinopathy(PDR).
METHODS: Retrospective analysis. Patients who presented to our hospital between Feburary 2012 and May 2014 with VH secondary to PDR treated with vitrectomy were included. All patients were divided into three groups according to the duration of VH. A group was less than 1mo for 22 eyes, B group was 1-3mo for 23 eyes, C group was more than 3mo for 25 eyes. All patients underwent intravitreal injection of ranibizumab 1-2wk before vitrectomy, and supplemented or finished panretinal photocoagulation(PRP)intraoperatively or postoperatively. Patients with cataract accepted phacoemulsification and intraocular lens implantation. Eyes filling silicone oil were implanted intraocular lens in the second phase. All patients were followed up 24 to 42mo(mean: 28.7mo). We assessed the intraoperative complications such as hemorrhage, iatrogenic retinal hole, and postoperative complications such as vitreous hemorrhage, neovascular glaucoma. Macular edema and best corrected visual acuity were observed at every follow-up.
RESULTS:There was no significant difference for other baseline data(P>0.05)but DR stage between three groups(P=0.033). There was significant difference of last follow up visual acuity between three groups(P<0.001). The significant difference can be seen between group A and B(P=0.03). The same outcome showed between Group A and C(P<0.001). There was no significant difference between Group B and C(P>0.05). The percentage of visual acuity was 0.5 and above in the three groups were: 41%, 23%, 0 respectively. The patients with visual acuity of less than 0.1 were 5%, 26% and 40% respectively. Silicone oil filling rate of three groups were: 9%, 26%, 40% respectively and there was no significantly difference between three groups on postoperative complications(P>0.05).
CONCLUSION: Patients with VH due to proliferative diabetic retinopathy undergoing early vitrectomy may get better visual acuity than who accepting delayed vitrectomy.