VISUAL OUTCOME AFTER PARS PLANA VITRECTOMY IN DIABETIC VITREOUS HEMORRHAGE

Abstract

Objectives: To determine visual outcome and frequency of complications af -ter pars plana vitrectomy in diabetic vitreous hemorrhage.
Methodology: This was interventional case series conducted at department
of ophthalmology, Khyber Institute of Ophthalmic Medical Sciences, Haya-tabad Medical Complex, Peshawar from January 2013 to June 2014. Known
diabetic patients above 16 years of age, having vitreous hemorrhage were
included. Standard three ports pars plana vitrectomy (PPV) with membrane
peeling, endolaser and without endotamponade by single study surgeon was
done in all patients. Best corrected visual acuity was noted pre operatively
and on 1st day, 2nd week and 8th week post operatively. P- value <0.05 was
considered statistically significant. Post-operative complications and visual
improvement were noted at final visit.
Results: Total of 50 patients having diabetic vitreous hemorrhage were in -cluded in the study. Mean age was 41.4 years. Male patients were 66%. Clear
lens was present in 46% patients and cortical lens vacuoles in 36% patients.
Fresh vitreous hemorrhage was present in 80%. Baseline and final post-oper-ative best corrected visual acuity logarithm minimal angle of resolution was
1.01± 0.17 and 0.74± 0.25 respectively. The difference in pre and post-oper-ative best corrected visual acuity logarithm minimal angle of resolution was
0.045 which was statistically significant. There were no post-operative compli-cations in 82% patients. Visual improvement was observed in 82%.
Conclusion: Most patients with diabetic vitreous hemorrhage regain or re-tain useful vision after PPV. Many patients may suffer late complications like
recurrent vitreous hemorrhage and retinal detachment after successful initial
surgery requiring secondary intervention.