A Comparison of Immediate and Delayed Vitrectomy for the Management of Vitreous Hemorrhage due to Proliferative Diabetic Retinopathy

作者：Fas**ender Janelle M; Ozkok Ahmet; Canter Hannah; Schaal Shlomit^*

来源：Ophthalmic Surgery Lasers & Imaging Retina, 2016, 47(1): 35-41.

DOI：10.3928/23258160-20151214-05

BACKGROUND AND OBJECTIVE: To compare immediate and delayed vitrectomy for the management of vitreous hemorrhage (VH) due to proliferative diabetic retinopathy (PDR).
PATIENTS AND METHODS: Retrospective review of 134 eyes receiving vitrectomy for non-clearing, PDR-associated VH. Primary outcome was area under the vision curve (AUC) in patients receiving immediate (<30 days) versus delayed (>30 days) vitrectomy with endolaser.
RESULTS: Forty-six eyes were included, with 17 undergoing immediate (<30 days) vitrectomy with endolaser and 29 undergoing delayed (>30 days) vitrectomy with endolaser. Time to vitrectomy was 14.8 days +/- 8.26 days compared to 629.6 days +/- 894.9 days in the immediate and delayed groups, respectively. AUC was significantly greater for patients undergoing delayed versus immediate vitrectomy (276.1 +/- 0.601 logMAR*time versus 165.7 +/- 0.761 logMAR*time; P<.0001). There was no difference in AUC post-operatively for delayed versus immediate surgery. Both groups required significantly less postoperative panretinal photocoagulation (P<.05). Preoperative and final visual acuities were equivalent (immediate: 1.86 +/- 0.99 and 0.35 +/- 0.25; P=.002; delayed: 1.71 +/- 1.05 and 0.31 +/- 0.34; P<.0001).
CONCLUSIONS: Immediate vitrectomy with endolaser for PDR-associated VH (<30 days) decreases time spent with vision loss and the need for adjunctive PRP. Modern vitrectomy is safe and may be considered earlier in VH management.

• 出版日期2016-1