Clinical Analysis Of 102 Cases (117 Eyes) Of Proliferative Diabetic Retinopathy With Surgical Treatment

Diabetes is a comlex metabolic disease. Proliferative diabetic retinopathy (PDR), as one of the complications of diabetes, frequently leads to the loss of visual acuity. If patients miss the early therapeutic opportunity, it may be hard to reverse their visual impairment even through multiple therapies. Nowdays, vitrectomy has been proved mainly efficient in treating PDR. With the intensive study of vitrectomy, the updated view of DR, the improvement of suigical skill and medical equipment, it will show the increasing operation success rates as well as decreasing postoperative complications.Objective: To observe the suigical effect of vitrectomy for treating PDR.Methods: The clinical datum of 117 eyes of 102 patients'who underwent vitrectomy by the same surgeon in Department of ocular fundus one in our hospital were retrospectively studied from Mar, 2008 to Dec, 2009. The postoperative visual acuity, the appropriate opportunity of operation, the application of tamponade and surgery-related complications were researched in our study.Results: (1) 36 eyes (85.71%) in PDR IV group, 27 eyes (69.23%) in PDR V group and 19 eyes (52.78%) in PDR VI group gained improvements in visual acuity after surgery. (2) According to the duration of vitreous hemorrhage in PDR IV group, the postoperative visual acuity improvement rate of less 2 months group was higher than that of 2～3 months group (P=0.032). There was no significant difference between 2～3 months group and more than 3 months group (P=1.000). (3) The total eyes with anatomically retinal attachment after one surgery were 112 (95.73%), including 41 eyes (97.62%) in PDR IV group, 38 eyes (97.44%) in PDR V group and 33 eyes (91.67%) in PDR VI group. (4) 19 eyes (85.71%)after vitrectomy presented recurrent vitreous hemorrhage.There were no statistical differences among PDR IV group, PDR V group and PDR VI group. There was a significant difference between preoperative PRP group and non-preoperative PRP group (P=0.042). (5) 5 eyes underwent pars plana vitrectomy combined with simultaneous lens removal. During the follow-up, phacoemulsification and intraocular lens implantation were operated on 3 eyes. (6) The incidence of postoperative INV was 5.98% (7 eyes).Conclusions:(1) The visual acuities of PDR patients can be well improved by pars plana vitrectomy. (2)To master the appropriate opportunity of surgery is prognostically crucial. (3)The application of tamponade mainly depends on preoperative or intraoperative retinal breaks. (4) Intraoperative laser photocoagulations are applied for definite ischemic retinal areas and breaks. When the media opacities are clear after surgery, fluorescein angiography and sequent PRP will achieve a better effect. (5)We suggest to evaluate the degree of cataract in every eye before surgery, to deal with lens individually during operations.