Abstract:AIM:To research blood pressure and blood glucose variability during peroperative period for patients with secondary neovasular glaucoma(NVG)after silicone oil removed in proliferative diabetic retinaopathy(PDR).
METHODS: Totally, 271 patients(271 eyes)undergone surgery of vitrectomy and silicon-oil tamponade combined with cataract were respective analyzed. Fourteen patients(14 eyes)with secondary NVG after silicon oil removed and randomly controlled group of no NVG according with ages, operation method in the same time were studied. The blood pressure and blood glucose variability during peroperative period was analyzed, and did comparison after excluded contralateral eye. The complications of 271 patients were surveyed in following-up period 1~12mo. The incidence of NVG, the time, blood pressure, blood glucose and glycated hemoglobin(Hbc%)variability during peroperative period was statisticed and compared by software of SPSS 11.0.
RESULTS: Fourteen eyes(5.2%)of 271 cases was with secondary NVG(female: 4 eyes, 28.6%; male: 10 eyes, 71.4%), average ages was 57.07 years(49~68 years). NVG presented in the 107~ 135d after vitrectomy and 7~45d(average 31.78d)after silicon-oil removed. Diabetes mellitus was 10~15(average 13.2)a. In NVG group, the variability of blood glucose was 4.0~10.2mmol/L(mean 8.52±3.24mmol/L), variable coefficient was 0.48. In NNVG group, the variability of blood glucose was 5.0~8.2mmol/L(mean 7.22±0.24mmol/L), variable coefficient was 0.43. It was significantly difference in comparison in variable coefficient(P<0.05). Hbc% was 10.52%±0.27% in NVG group and 7.60%±1.34% in NNVG group, there was a statistical difference(P<0.05). The average systolic blood pressure(SBP)was 152.3±15.1mmHg(140~180mmHg)with variable coefficient was 0.099 in NVG group and 131.4±0.1mmHg(120~150mmHg)with variable coefficient 0.061 in NVG group. While the average diastolic blood pressure(DBP)was 92.3±11.1mmHg(50~110mmHg)with variable coefficient 0.11 in NVG group and 87.3±8.1mmHG(80~100mmHg)with variable coefficient 0.08 in NNVG group. Compared the two groups, there were differences in variable coefficient(P<0.05). Blood glucose variability of perioperative in NVG group was significantly greater than that in NNVG group. Compared between the two groups, variability of daytime SBP and night DBP in NVG group were more than those in NNVG group with statistically significant differences(P<0.05). Perioperative blood glucose and blood pressure variability showed no statistical significance in 14 patients after taking oil surgery and vitrectomy with silicone oil tamponade.
CONCLUSION: There are significant variability on fasting blood glucose, daytime SBP and night DBP during perioperative in PDR patients with secondary NVG. It might be occurred 1wk after silicone oil removal surgery.