Dependence of Post-Operative Visual Acuity and Pre-Operative State of Patients in Surgeries of Complicated Diabetic Retinopathy

Dependence of Post-Operative Visual Acuity and Pre-Operative State of Patients in Surgeries of Complicated Diabetic Retinopathy

M. Zavorkova, L. Prochazkova, T. Benda (Usti nad Labem, Czech Republic)

Advantages:

Pars plana vitrectomy (PPV) helped us to resolve complications of diabetic retinopathy (DR) including tractional retinal detachment.

Methods:

Authors report the results of surgical interventions, performed between 2004-2009 to handle various complications of DR at the Department of Ophthalmology, Masaryk Hospital in Ústi nad Labem. PPV was performed in 106 eyes of 94 patients. 39% of the eyes had suffered mild DR, 56% serious DR and 5% serious DR complications caused by iris neovascularisation. Pre-operative diagnoses were haemophthalmus in 59%, epiretinal membrane in 5% and tractional retinal detachment in 35%. The patients were divided into 5 groups according to post-operative visual acuity (VA): I. 1,0-0,33, II. 0,25 – 0,1, III. 0,08 ˆ 0,05, IV. 0,04 – 0,02, V. zero letters are read correctly. Groups VI. and V. displayed higher occurence of patients with type 1 diabetes mellitus (DM), patients with cerebral vessel occlusion and patients after limb amputations. Higher percentage of patients without pre-operative photocoagulation was recorded in group V. Groups I. and II. included higher number of patients who had been treated for DM for long time; this may be thanks to early capture and better compensation of DM.

Effectiveness / Safety:

The anatomical retina finding improved after PPV. Improved anatomical results did not correspond with improvements of VA in all cases.

Take home message:

Good post-operative VA in our group did not depend on the duration of DM, but rather on compensation of DM, general pre-operative condition of the patient, and on pre-operative eye care and photocoagulation.