A COMPARATIVE STUDY BETWEEN EARLY VERSUS DEFERRED VITRECTOMY IN MANAGEMENT OF UNCOMPLICATED DIABETIC VITREOUS HAEMORRHAGE | ||||
| Egyptian Journal of Clinical Ophthalmology | ||||
| Article 4, Volume 3, Issue 1, June 2020, Page 25-39 PDF (591.82 K) | ||||
| Document Type: Original articles: include clinical trials, interventional research, Basic researches and clinically relevant laboratory investigations | ||||
| DOI: 10.21608/ejco.2020.162968 | ||||
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| Authors | ||||
| Abd Ellateef, M.1; Abd El-Badie, M.1; Yossef, A.2 | ||||
| 1Ophthalmology dept., Faculty of Medicine, Al-Azhar Univ., Assiut, Egyp | ||||
| 2Ophthalmology dept., Faculty of Medicine, Al-Azhar Univ., Assiut, Egypt | ||||
| Abstract | ||||
| Objective: To determine the visual outcome and frequency of complications after pars plana vitrectomy in cases of diabetic vitreous hemorrhage underwent early (within one month of onset) versus delayed vitrectomy (after one month of onset). Patients and Methods: Thirty eyes of 30 diabetic patients presented by uncomplicated diabetic vitreous haemorrhage divided into two groups; each group consists of fifteen eyes. Group Aincluded the patients presented by diabetic vitreous haemorrhage and undergone early vitrectomy within one month of onset. Group B included the patients presented by diabetic vitreous haemorrhage after one month of onset and undergone delayed vitrectomy after one month of onset. Results: In group A, we found postoperative visual acuity ranges from 6/60 to 6/12 (1.00 to 0.30 Log MAR) with mean 0.58 (Log MAR). In group B postoperative visual acuity ranges from 3/60 to 6/18 (1.30 to 0.48 Log MAR) with mean 0.75 (Log MAR). Patients of type I DM underwent early vitrectomy have 0.62 (Log MAR) final mean BCVA, while those underwent delayed vitrectomy have 0.75 (Log MAR) final mean BCVA. P-value (0.04) shows statistical significance among both groups. Patients of type II DM underwent early vitrectomy have 0.56 (Log MAR) final mean BCVA, while those underwent delayed vitrectomy have 0.75 (Log MAR) final mean BCVA, P-value (0.42) shows statistical significance. The mean first day IOP was 19.13 mmHg in group A vs 17.8 mmHg in group B. No patients in group < br />A had a first day IOP recorded above 23 mmHg. In group B, however, two patients had a 1st day IOP above 23 mmHg and required a short course of oral acetazolamide and topical antiglaucoma medications. In contrast, three patients had postoperative hypotony (IOP<10mmHg) in group A compared to one patient in group B. However, at the 1st week follow-up appointment all IOPs had returned to within normal limits. P-value (0.364) shows no statistical significance among both groups Conclusion: Visual results after PPV in diabetic vitreous hemorrhage show that most of patients regain or retain useful vision. Early vitrectomy with endolaser retinal photocoagulation for diabetic vitreous haemorrhage (<30 days) decreases time spent with vision loss and the need for adjunctive PRP especially in patients of type I DM, recurrent vitreous haemorrhage and cases of premacular subhyaloid haem-orrhage. A few proportions of patients may develop late complications like recurrent vitreous hemorrhage and retinal detachment after successful PPV requiring secondary intervention. | ||||
| Keywords | ||||
| Diabetic retinopathy; Vitreous haemorrhage; Vitrectomy; Laser photocoagulation and anti-VEGF | ||||
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