Photocoagulation Up to Ora Serrata in Diabetic Vitrectomy to Prevent Recurrent Vitreous Hemorrhage
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Purpose: To evaluate the role of performing photocoagulation up to ora serrata during vitrectomy in preventing recurrent vitreous hemorrhage (VH) in patients undergoing pars plana vitrectomy (PPV) for proliferative diabetic retinopathy (PDR). Methods: This retrospective, nonrandomized study included 60 eyes from 60 patients who had undergone PPV for VH due to PDR. These patients were divided into two groups: group 1, those who underwent photocoagulation up to ora serrata using the scleral indentation technique during surgery; and group 2, those who did not undergo scleral indentation when photocoagulation and underwent photocoagulation up to vortex veins. Their hospital records were analyzed to investigate the recurrence rate of VH, the time until recurrence of VH after surgery, logarithm of the minimal angle of resolution (logMAR) best-corrected visual acuity (BCVA) measured before surgery and at 1, 2, and 3 years after surgery, and the occurrence of complications such as neovascular glaucoma (NVG) during follow-up. Results: Group 1 exhibited lower recurrence rate of VH (2 of 30 [6.7%] vs. 10 of 30 [33.3%], p = 0.01) and lower occurrence of postoperative NVG (2 of 30 [6.7%] vs. 8 of 30 [26.7%], p = 0.038) compared with group 2. There were no statistically significant differences in logMAR BCVA measured at 1, 2, and 3 years between the two groups (at 1 year: 0.54 ± 0.43 vs. 0.54 ± 0.44, p = 0.954; at 2 years: 0.48 ± 0.47 vs. 0.55 ± 0.64, p = 0.235; at 3 years: 0.51 ± 0.50 vs. 0.61 ± 0.77, p = 0.200). Logistic regression analysis showed that among several factors that could affect recurrence rate of VH, only range of photocoagulation performed was a statistically significant factor (odds ratio, 0.119; 95% confidence interval, 0.022–0.659; p = 0.015). Conclusions: Photocoagulation treatment over a wider range with scleral indentation could be a beneficial adjunct procedure for preventing postoperative recurrent VH following diabetic vitrectomy.
Abstract
Purpose: To evaluate the role of performing photocoagulation up to ora serrata during vitrectomy in preventing recurrent vitreous hemorrhage (VH) in patients undergoing pars plana vitrectomy (PPV) for proliferative diabetic retinopathy (PDR). Methods: This retrospective, nonrandomized study included 60 eyes from 60 patients who had undergone PPV for VH due to PDR. These patients were divided into two groups: group 1, those who underwent photocoagulation up to ora serrata using the scleral indentation technique during surgery; and group 2, those who did not undergo scleral indentation when photocoagulation and underwent photocoagulation up to vortex veins. Their hospital records were analyzed to investigate the recurrence rate of VH, the time until recurrence of VH after surgery, logarithm of the minimal angle of resolution (logMAR) best-corrected visual acuity (BCVA) measured before surgery and at 1, 2, and 3 years after surgery, and the occurrence of complications such as neovascular glaucoma (NVG) during follow-up. Results: Group 1 exhibited lower recurrence rate of VH (2 of 30 [6.7%] vs. 10 of 30 [33.3%], p = 0.01) and lower occurrence of postoperative NVG (2 of 30 [6.7%] vs. 8 of 30 [26.7%], p = 0.038) compared with group 2. There were no statistically significant differences in logMAR BCVA measured at 1, 2, and 3 years between the two groups (at 1 year: 0.54 ± 0.43 vs. 0.54 ± 0.44, p = 0.954; at 2 years: 0.48 ± 0.47 vs. 0.55 ± 0.64, p = 0.235; at 3 years: 0.51 ± 0.50 vs. 0.61 ± 0.77, p = 0.200). Logistic regression analysis showed that among several factors that could affect recurrence rate of VH, only range of photocoagulation performed was a statistically significant factor (odds ratio, 0.119; 95% confidence interval, 0.022–0.659; p = 0.015). Conclusions: Photocoagulation treatment over a wider range with scleral indentation could be a beneficial adjunct procedure for preventing postoperative recurrent VH following diabetic vitrectomy.
참고문헌 (36)
- Norton EW, "A new approach to the treatment of selected retinal detachments secondary to vitreous loss at cataract surgery", Trans Am Ophthalmol Soc, 69, pp.63~70 (1971)
- Yang CM, "Surgical treatment for diabetic retinopathy : 5-year experience", J Formos Med Assoc, 97, pp.477~484 (1998)
- Novak MA, "Vitreous hemorrhage after vitrectomy for diabetic retinopathy", Ophthalmology, 91, pp.1485~1489 (1984)
- Schachat AP, "Complications of vitreous surgery for diabetic retinopathy. II. Postoperative complications", Ophthalmology, 90, pp.522~530 (1983)
- Tolentino FI, "Vitreous hemorrhage after closed vitrectomy for proliferative diabetic retinopathy", Ophthalmology, 96, pp.1495~1500 (1989)
- Brown GC, "Reoperation following diabetic vitrectomy", Arch Ophthalmol, 110, pp.506~510 (1992)
- Han DP, "Outpatient fluid-air exchange for severe postvitrectomy diabetic vitreous hemorrhage : long-term results and complications", Retina, 11, pp.309~314 (1991)
- Hershberger VS, "Fibrovascular ingrowth at sclerotomy sites in vitrectomized diabetic eyes with recurrent vitreous hemorrhage : ultrasound biomicroscopy findings", Ophthalmology, 111, pp.1215~1221 (2004)
- West JF, "Fibrovascular ingrowth and recurrent haemorrhage following diabetic vitrectomy", Br J Ophthalmol, 84, pp.822~825 (2000)
- Lewis H, "Anterior hyaloidal fibrovascular proliferation after diabetic vitrectomy", Am J Ophthalmol, 104, pp.607~613 (1987)
- Koch FH, "Pars plana incisions of four patients : histopathology and electron microscopy", Br J Ophthalmol, 79, pp.486~493 (1995)
- Kreiger AE, "Wound complications in pars plana vitrectomy", Retina, 13, pp.335~344 (1993)
- Hotta K, "Ultrasound biomicroscopy for examination of the sclerotomy site in eyes with proliferative diabetic retinopathy after vitrectomy", Retina, 20, pp.52~58 (2000)
- The Diabetic Retinopathy Study Research Group, "Photocoagulation treatment of proliferative diabetic retinopathy:clinical application of Diabetic Retinopathy Study (DRS)findings, DRS report number 8", Ophthalmology, 88, pp.583~600 (1981)
- Yan H, "Reasons for and management of postvitrectomy vitreous hemorrhage in proliferative diabetic retinopathy", Curr Eye Res, 35, pp.308~313 (2010)
- Aylward GW, "Extensive argon laser photocoagulation in the treatment of proliferative diabetic retinopathy", Br J Ophthalmol, 73, pp.197~201 (1989)
- Reddy VM, "Quantitation of retinal ablation in proliferative diabetic retinopathy", Am J Ophthalmol, 119, pp.760~766 (1995)
- The DRVS Research Group, "Two-year course of visual acuity in severe proliferative diabetic retinopathy with conventional management : Diabetic Retinopathy Vitrectomy Study(DRVS)report #1", Ophthalmology, 92, pp.492~502 (1985)
- Early Treatment Diabetic Retinopathy Study Research Group, "Fundus photographic risk factors for progression of diabetic retinopathy : ETDRS report number 12", Ophthalmology, 98(5 Suppl), pp.823~833 (1991)
- Wand M, "Neovascular glaucoma following pars plana vitrectomy for complications of diabetic retinopathy", Ophthalmic Surg, 21, pp.113~118 (1990)
- Jung CI, "Comparison of surgical result of vitrectomy vs combined phacoemulsification and vitrectomy in patients with diabetic vitreous hemorrhage", J Korean Ophthalmol Soc, 41, pp.2375~2380 (2000)
- McDonald HR, "Macular edema following panretinal photocoagulation", Retina, 5, pp.5~10 (1985)
- Kim MK, "Effective dose of laser photocoagulation in proliferative diabetic retnopathy", J Korean Ophthalmol Soc, 39, pp.111~118 (1998)
- Marra KV, "Case-matched comparison of vitrectomy, peripheral retinal endolaser, and endocyclophotocoagulation versus standard care in neovascular glaucoma", Retina, 35, pp.1072~1083 (2015)
- Sabti K, "Ultrasound biomicroscopy of sclerotomy sites : the effect of vitreous shaving around sclerotomy sites during pars plana vitrectomy", Retina, 21, pp.464~468 (2001)
- 김인근, "Comparison of the 20-Gauge Conventional Vitrectomy Technique with the 23-Gauge Releasable Suture Vitrectomy Technique", Korean Journal of Ophthalmology, 27(1), pp.12~18 (2013), 대한안과학회
- Yoon JT, "Systemic risk factors for postoperative vitreous hemorrhage following diabetic vitrectomy", J Korean Ophthalmol Soc, 42, pp.434~440 (2001)
- Thompson JT, "Prognostic indicators of success and failure in vitrectomy for diabetic retinopathy", Ophthalmology, 93, pp.290~295 (1986)
- Yeh PT, "Cryotherapy of the anterior retina and sclerotomy sites in diabetic vitrectomy to prevent recurrent vitreous hemorrhage : an ultrasound biomicroscopy study", Ophthalmology, 112, pp.2095~2102 (2005)
- Ng EY, "A comparison of laser photocoagulation with cryotherapy for threshold retinopathy of prematurity at 10 years: part 1. Visual function and structural outcome", Ophthalmology, 109, pp.928~935 (2002)
- Yang CM, "Intravitreal long-acting gas in the prevention of early postoperative vitreous hemorrhage in diabetic vitrectomy", Ophthalmology, 114, pp.710~715 (2007)
- Baget-Bernaldiz M, "Risk factors for recurrent vitreous hemorrhage in type 2diabetes mellitus patients after posterior vitrectomy", J Clin Med, 12, pp.2989~ (2023)
- Landers MB, "Management of post-vitrectomy persistent vitreous hemorrhage in pseudophakic eyes", Am J Ophthalmol, 136, pp.989~993 (2003)
- Cheema RA, "Role of residual vitreous cortex removal in prevention of postoperative vitreous hemorrhage in diabetic vitrectomy", Int Ophthalmol, 30, pp.137~142 (2010)
- Qiu CY, "A pilot study of viscoelastic agent to prevent recurrent vitreous hemorrhage after vitrectomy for proliferative diabetic retinopathy", BMC Ophthalmol, 22, pp.509~ (2022)
- Kim DY, "Ultra-widefield fluorescein angiographic findings in patients with recurrent vitreous hemorrhage after diabetic vitrectomy", Invest Ophthalmol Vis Sci, 55, pp.7040~7046 (2014)