Objective To investigate the relationship of macular microstructure and visual prognosis of micro-invasive vitrectomy for diabetic vitreous hemorrhage. Methods Fifty-three patients (53 eyes) with diabetic vitreous hemorrhage who underwent microinvasive vitrectomy were enrolled in this retrospective study. The preoperative and postoperative best-corrected visual acuities (BCVA) were recorded. The central foveal thicknesses (CFT) were measured after surgery by spectral domainoptical coherence tomography (SD-OCT). The median follow-up time was (12.81plusmn;8.22) months, ranging from six to 36 months. According to the results of SD-OCT at last follow-up time, macular edema (ME), epiretinal membrane (ERM), interrupted inside and outside section (IS/OS) and interrupted external limiting membrane (ELM) were macular abnormalities were observed. The preoperative and postoperative BCVA of different macular abnormalities were comparatively analyzed. The correlation between BCVA and macular microstructure were analyzed. Results The CFT was ranged from 103.00 mu;m to 498.00 mu;m,with the mean of（251.12plusmn;90.23） mu;m. Macular abnormalities were observed in 37 eyes (69.8%), and normal macula in 16 eyes (30.2%). Among 37 eyes with macular abnormalities, there were 20 eyes (37.7%) with ME, 12 eyes (22.6%) with ERM, 33 eyes (62.3%) with interrupted IS/OS, and 20 eyes (37.7%) with interrupted ELM. The BCVA of ME eyes decreased significantly than that in nonME eyes （t=-2.09，P＜0.05). The difference of BCVA in ERM and nonERM eyes was not statistically significant (t=-1.10,P＞0.05). The BCVA of interrupted IS/OS eyes decreased significantly more than that in continuous IS/OS eyes （t=-4.33,P＜0.05). The BCVA of interrupted ELM eyes decreased significantly more than that in continuous ELM eyes (t=-2.58, P＜0.05). The postoperative BCVA correlated positively with integrity of the IS/OS junction, CFT, and whether ME or not (r=7.65, 8.21, 4.99; P＜0.05), but insignificantly associated with integrity of the ELM and whether ERM or not (r=0.01, 0.82; P＞0.05). Conclusion The final visual acuity of patients with diabetic vitreous hemorrhage after micro-invasive vitrectomy is related to the CFT，the status of IS/OS junction, whether ME or not, but not related to integrity of the ELM or whether ERM or not.
ObjectiveTo observe the effect and complications of vitrectomy combined with intraocular silicon oil or C3F8 filling for proliferative diabetic retinopathy (PDR). MethodsEighty-six consecutive patients (101 eyes) with PDR-related vitreous hemorrhage who underwent primary standard three-port vitrectomy and intraocular tamponade of silicone oil or C3F8 were included in this retrospective study. They were divided into silicone oil group and C3F8 groups. There was no statistically significant difference between these two groups of patients for gender, age, duration of diabetes, fasting glucose, history of hypertension, diabetic kidney disease history, history of cardiac and vascular diseases, body mass index and smoking history. There was statistically significant difference between these two groups of patients for visual acuity (Z=-2.604, P=0.009). There was no statistically significant difference between these two groups of patients for intraocular pressure before surgery (Z=0.064, P=0.949). The mean follow-up was (20.3±16.4) months with a range from 1 to 47 months. The patients were followed up for visual acuity, intraocular pressure, neovascular glaucoma (NVG), the incidence of retinal detachment, recurrent vitreous hemorrhage, and repeated operation for complications. ResultsVisual acuity (t=-3.932, -8.326; P=0.000, 0.000) and intraocular pressure (t=-3.159, -2.703; P=0.006, 0.009) were changed significantly after surgery for both groups. Between these two groups after surgery, there were significant differences of visual acuity (Z=-1.879, P=0.040), intraocular pressure (Z=-3.593, P=0.000), and complications (revision operation, retinal detachment, recurrent vitreous hemorrhage and NVG) (t=-2.777, -2.102, -2.308, -2.013; P < 0.05). ConclusionIntraocular silicone oil tamponade can reduce the postoperative complications of PDR, especially for severe retinal neovascularization, exudation associated with retinal edema.