Cargando…

Incidence of and Risk Factors for Postoperative Hyphema After 23-Gauge Pars Plana Vitrectomy for Proliferative Diabetic Retinopathy

PURPOSE: We aim to investigate the incidence, clinical course, and risk factors for developing postoperative hyphema after 23-gauge pars plana vitrectomy (PPV) for patients with proliferative diabetic retinopathy (PDR) without neovascularization of the iris or angles and neovascular glaucoma (NVG)....

Descripción completa

Detalles Bibliográficos
Autores principales: Nie, Yu-Hong, Zhang, Yu, Li, Fan, Wang, Qiong, Xu, A-Min, Chen, Zhen
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8560055/
https://www.ncbi.nlm.nih.gov/pubmed/34737621
http://dx.doi.org/10.2147/IJGM.S332485
_version_ 1784592867498393600
author Nie, Yu-Hong
Zhang, Yu
Li, Fan
Wang, Qiong
Xu, A-Min
Chen, Zhen
author_facet Nie, Yu-Hong
Zhang, Yu
Li, Fan
Wang, Qiong
Xu, A-Min
Chen, Zhen
author_sort Nie, Yu-Hong
collection PubMed
description PURPOSE: We aim to investigate the incidence, clinical course, and risk factors for developing postoperative hyphema after 23-gauge pars plana vitrectomy (PPV) for patients with proliferative diabetic retinopathy (PDR) without neovascularization of the iris or angles and neovascular glaucoma (NVG). METHODS: This retrospective study included 155 consecutive eyes from 124 patients with at least three-month follow-up who underwent PPV for PDR without neovascularization of the iris or angles and NVG. Demographic data, surgery notes, postoperative hyphema assessment, intraocular pressure (IOP), and the surgical outcome were recorded. RESULTS: Postoperative hyphema occurred in 18 of 155 eyes (11.6%), with 14 of those having hyphema on day 1, and 4 having hyphema on days 7–20. Of the 18 eyes, only 3 (16.7%) had normal IOP, and immediate intraocular hypertension was observed in 15 (83.3%). Seven eyes required anterior chamber paracentesis and five needed anterior chamber irrigation. The average time for absorption of the hyphema was 13.1 days, and IOP was controlled in all cases. There was a significant correlation between membrane removal and the development of hyphema (OR = 5.65 and 95% CI: 1.190–25.203; p = 0.013). No recurrence of hyphema was observed. In patients with hyphema, the final best corrected visual acuity (BCVA) was 1.75 ± 0.84 logMAR, which improved significantly compared to the initial BCVA of 2.20 ± 0.65 logMAR (t = 3.893; p = 0.001), and the final anatomic success rate was 100%. CONCLUSION: The development of hyphema is not uncommon after PPV for patients with PDR without neovascularization of the iris or angles and NVG, and membrane removal is a risk factor for postoperative hyphema. The timely management of hyphema ensures that hyphema does not affect the visual recovery or the final anatomical success.
format Online
Article
Text
id pubmed-8560055
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher Dove
record_format MEDLINE/PubMed
spelling pubmed-85600552021-11-03 Incidence of and Risk Factors for Postoperative Hyphema After 23-Gauge Pars Plana Vitrectomy for Proliferative Diabetic Retinopathy Nie, Yu-Hong Zhang, Yu Li, Fan Wang, Qiong Xu, A-Min Chen, Zhen Int J Gen Med Original Research PURPOSE: We aim to investigate the incidence, clinical course, and risk factors for developing postoperative hyphema after 23-gauge pars plana vitrectomy (PPV) for patients with proliferative diabetic retinopathy (PDR) without neovascularization of the iris or angles and neovascular glaucoma (NVG). METHODS: This retrospective study included 155 consecutive eyes from 124 patients with at least three-month follow-up who underwent PPV for PDR without neovascularization of the iris or angles and NVG. Demographic data, surgery notes, postoperative hyphema assessment, intraocular pressure (IOP), and the surgical outcome were recorded. RESULTS: Postoperative hyphema occurred in 18 of 155 eyes (11.6%), with 14 of those having hyphema on day 1, and 4 having hyphema on days 7–20. Of the 18 eyes, only 3 (16.7%) had normal IOP, and immediate intraocular hypertension was observed in 15 (83.3%). Seven eyes required anterior chamber paracentesis and five needed anterior chamber irrigation. The average time for absorption of the hyphema was 13.1 days, and IOP was controlled in all cases. There was a significant correlation between membrane removal and the development of hyphema (OR = 5.65 and 95% CI: 1.190–25.203; p = 0.013). No recurrence of hyphema was observed. In patients with hyphema, the final best corrected visual acuity (BCVA) was 1.75 ± 0.84 logMAR, which improved significantly compared to the initial BCVA of 2.20 ± 0.65 logMAR (t = 3.893; p = 0.001), and the final anatomic success rate was 100%. CONCLUSION: The development of hyphema is not uncommon after PPV for patients with PDR without neovascularization of the iris or angles and NVG, and membrane removal is a risk factor for postoperative hyphema. The timely management of hyphema ensures that hyphema does not affect the visual recovery or the final anatomical success. Dove 2021-10-28 /pmc/articles/PMC8560055/ /pubmed/34737621 http://dx.doi.org/10.2147/IJGM.S332485 Text en © 2021 Nie et al. https://creativecommons.org/licenses/by-nc/3.0/This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/ (https://creativecommons.org/licenses/by-nc/3.0/) ). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php).
spellingShingle Original Research
Nie, Yu-Hong
Zhang, Yu
Li, Fan
Wang, Qiong
Xu, A-Min
Chen, Zhen
Incidence of and Risk Factors for Postoperative Hyphema After 23-Gauge Pars Plana Vitrectomy for Proliferative Diabetic Retinopathy
title Incidence of and Risk Factors for Postoperative Hyphema After 23-Gauge Pars Plana Vitrectomy for Proliferative Diabetic Retinopathy
title_full Incidence of and Risk Factors for Postoperative Hyphema After 23-Gauge Pars Plana Vitrectomy for Proliferative Diabetic Retinopathy
title_fullStr Incidence of and Risk Factors for Postoperative Hyphema After 23-Gauge Pars Plana Vitrectomy for Proliferative Diabetic Retinopathy
title_full_unstemmed Incidence of and Risk Factors for Postoperative Hyphema After 23-Gauge Pars Plana Vitrectomy for Proliferative Diabetic Retinopathy
title_short Incidence of and Risk Factors for Postoperative Hyphema After 23-Gauge Pars Plana Vitrectomy for Proliferative Diabetic Retinopathy
title_sort incidence of and risk factors for postoperative hyphema after 23-gauge pars plana vitrectomy for proliferative diabetic retinopathy
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8560055/
https://www.ncbi.nlm.nih.gov/pubmed/34737621
http://dx.doi.org/10.2147/IJGM.S332485
work_keys_str_mv AT nieyuhong incidenceofandriskfactorsforpostoperativehyphemaafter23gaugeparsplanavitrectomyforproliferativediabeticretinopathy
AT zhangyu incidenceofandriskfactorsforpostoperativehyphemaafter23gaugeparsplanavitrectomyforproliferativediabeticretinopathy
AT lifan incidenceofandriskfactorsforpostoperativehyphemaafter23gaugeparsplanavitrectomyforproliferativediabeticretinopathy
AT wangqiong incidenceofandriskfactorsforpostoperativehyphemaafter23gaugeparsplanavitrectomyforproliferativediabeticretinopathy
AT xuamin incidenceofandriskfactorsforpostoperativehyphemaafter23gaugeparsplanavitrectomyforproliferativediabeticretinopathy
AT chenzhen incidenceofandriskfactorsforpostoperativehyphemaafter23gaugeparsplanavitrectomyforproliferativediabeticretinopathy