ORIGINAL ARTICLES
Predictive clinical features and outcomes of vitrectomy for proliferative diabetic retinopathy
1 Tennent Institute of Ophthalmology, Gartnavel Hospital, Glasgow, Scotland, UK
2 Moorfields Eye Hospital, London, UK
Correspondence to:
Dr D Yorston, Tennent Institute of Ophthalmology, Gartnavel Hospital, Great Western Road, Glasgow G12 0YN, Scotland, UK; dhyorston{at}enterprise.net
Objective: To study the preoperative characteristics, complications and outcomes of vitrectomy for proliferative diabetic retinopathy and to identify any factors that may predict visual outcome.
Methods: Prospective study of 174 consecutive vitrectomies in 148 patients, with a minimum follow-up of 4 months.
Results: 41 (27.7%) patients had a vision of <6/60 in their better eye at presentation. Posterior retinal breaks occurred in 47 (27.0%) eyes. Postoperative complications included vitreous cavity haemorrhage in 37 (22.0%) eyes, retinal detachment in five eyes (3.0%), and rubeotic glaucoma in five eyes (3.0%). 124 (74.7%) eyes improved by at least 0.3 LogMAR units, and 15 (9.0%) worsened by at least 0.3 LogMAR units. 119 (71.7%) eyes had a visual acuity of 6/60 or better, and 27 (16.3%) were counting fingers or worse. Only 16 (11.1%) patients had a vision of <6/60 in both eyes at latest follow-up. Preoperative vision in both the operated eye and the contralateral eye, macular detachment, and long-acting intraocular tamponade were independent predictors of poor postoperative vision, but this model accounted for only a small proportion of the observed variation in outcomes.
Conclusions: Major complications are rare after vitrectomy for proliferative diabetic retinopathy, and >70% of eyes will regain vision of 6/60 or better. Visual outcomes remain unpredictable.
Competing interests: None declared.
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