Characteristics and Outcomes of Pars Plana Vitrectomy for Proliferative Diabetic Retinopathy Patients in a Limited Resource Tertiary Center over an Eight-Year Period

© 2019 Janejit Choovuthayakorn et al. Purpose. To report characteristics and visual results in patients with PDR-associated complications following pars plana vitrectomy (PPV) in a tertiary center over an eight-year period. Methods. Medical records of diabetic retinopathy patients receiving PPV betw...

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Main Authors: Janejit Choovuthayakorn, Preeyanuch Khunsongkiet, Direk Patikulsila, Nawat Watanachai, Paradee Kunavisarut, Voraporn Chaikitmongkol, Nimitr Ittipunkul
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Published: 2019
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http://cmuir.cmu.ac.th/jspui/handle/6653943832/65805
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spelling th-cmuir.6653943832-658052019-08-05T04:41:30Z Characteristics and Outcomes of Pars Plana Vitrectomy for Proliferative Diabetic Retinopathy Patients in a Limited Resource Tertiary Center over an Eight-Year Period Janejit Choovuthayakorn Preeyanuch Khunsongkiet Direk Patikulsila Nawat Watanachai Paradee Kunavisarut Voraporn Chaikitmongkol Nimitr Ittipunkul Medicine © 2019 Janejit Choovuthayakorn et al. Purpose. To report characteristics and visual results in patients with PDR-associated complications following pars plana vitrectomy (PPV) in a tertiary center over an eight-year period. Methods. Medical records of diabetic retinopathy patients receiving PPV between January 2007 and December 2014 for PDR-related complications were reviewed. Results. A total of 890 consecutive PDR patients were included in the study. PPVs were performed for tractional retinal detachment (36.6%), persistent vitreous hemorrhage (VH) (35.4%), combined tractional and rhegmatogenous retinal detachment (14.5%), and vitreoretinal abnormalities (13.5%), respectively. Preoperative intravitreal bevacizumab injection (IVB) within two weeks prior to PPV and 23G vitrectomy systems was found to decrease the risk for intraoperative retinal break development (P=0.045 and P=0.015, respectively). The incidence of early dense postoperative VH decreased significantly with the administration of preoperative or intraoperative IVB at the end of PPV. Postoperative visual results significantly correlated with the initial visual acuity level, intraoperative retinal break development, and retained silicone oil tamponade at the final visit (P<0.001, P=0.040, and P=0.044, respectively). Administration of adjuvant IVB either before or at the end of PPV had no significant association with the final visual outcomes. Conclusions. This study reported an improvement in visual acuity in nearly half of patients receiving PPV for PDR-associated complications in a limited resource center. The incidence of intraoperative retinal break and early postoperative VH decreased significantly with the application of IVB injections. Poor final visual outcomes were related to the lower initial visual acuity levels, intraoperative retinal breaks, and postoperative retained silicone oil. 2019-08-05T04:41:30Z 2019-08-05T04:41:30Z 2019-01-01 Journal 20900058 2090004X 2-s2.0-85064013934 10.1155/2019/9481902 https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85064013934&origin=inward http://cmuir.cmu.ac.th/jspui/handle/6653943832/65805
institution Chiang Mai University
building Chiang Mai University Library
country Thailand
collection CMU Intellectual Repository
topic Medicine
spellingShingle Medicine
Janejit Choovuthayakorn
Preeyanuch Khunsongkiet
Direk Patikulsila
Nawat Watanachai
Paradee Kunavisarut
Voraporn Chaikitmongkol
Nimitr Ittipunkul
Characteristics and Outcomes of Pars Plana Vitrectomy for Proliferative Diabetic Retinopathy Patients in a Limited Resource Tertiary Center over an Eight-Year Period
description © 2019 Janejit Choovuthayakorn et al. Purpose. To report characteristics and visual results in patients with PDR-associated complications following pars plana vitrectomy (PPV) in a tertiary center over an eight-year period. Methods. Medical records of diabetic retinopathy patients receiving PPV between January 2007 and December 2014 for PDR-related complications were reviewed. Results. A total of 890 consecutive PDR patients were included in the study. PPVs were performed for tractional retinal detachment (36.6%), persistent vitreous hemorrhage (VH) (35.4%), combined tractional and rhegmatogenous retinal detachment (14.5%), and vitreoretinal abnormalities (13.5%), respectively. Preoperative intravitreal bevacizumab injection (IVB) within two weeks prior to PPV and 23G vitrectomy systems was found to decrease the risk for intraoperative retinal break development (P=0.045 and P=0.015, respectively). The incidence of early dense postoperative VH decreased significantly with the administration of preoperative or intraoperative IVB at the end of PPV. Postoperative visual results significantly correlated with the initial visual acuity level, intraoperative retinal break development, and retained silicone oil tamponade at the final visit (P<0.001, P=0.040, and P=0.044, respectively). Administration of adjuvant IVB either before or at the end of PPV had no significant association with the final visual outcomes. Conclusions. This study reported an improvement in visual acuity in nearly half of patients receiving PPV for PDR-associated complications in a limited resource center. The incidence of intraoperative retinal break and early postoperative VH decreased significantly with the application of IVB injections. Poor final visual outcomes were related to the lower initial visual acuity levels, intraoperative retinal breaks, and postoperative retained silicone oil.
format Journal
author Janejit Choovuthayakorn
Preeyanuch Khunsongkiet
Direk Patikulsila
Nawat Watanachai
Paradee Kunavisarut
Voraporn Chaikitmongkol
Nimitr Ittipunkul
author_facet Janejit Choovuthayakorn
Preeyanuch Khunsongkiet
Direk Patikulsila
Nawat Watanachai
Paradee Kunavisarut
Voraporn Chaikitmongkol
Nimitr Ittipunkul
author_sort Janejit Choovuthayakorn
title Characteristics and Outcomes of Pars Plana Vitrectomy for Proliferative Diabetic Retinopathy Patients in a Limited Resource Tertiary Center over an Eight-Year Period
title_short Characteristics and Outcomes of Pars Plana Vitrectomy for Proliferative Diabetic Retinopathy Patients in a Limited Resource Tertiary Center over an Eight-Year Period
title_full Characteristics and Outcomes of Pars Plana Vitrectomy for Proliferative Diabetic Retinopathy Patients in a Limited Resource Tertiary Center over an Eight-Year Period
title_fullStr Characteristics and Outcomes of Pars Plana Vitrectomy for Proliferative Diabetic Retinopathy Patients in a Limited Resource Tertiary Center over an Eight-Year Period
title_full_unstemmed Characteristics and Outcomes of Pars Plana Vitrectomy for Proliferative Diabetic Retinopathy Patients in a Limited Resource Tertiary Center over an Eight-Year Period
title_sort characteristics and outcomes of pars plana vitrectomy for proliferative diabetic retinopathy patients in a limited resource tertiary center over an eight-year period
publishDate 2019
url https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85064013934&origin=inward
http://cmuir.cmu.ac.th/jspui/handle/6653943832/65805
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