Objective To evaluate ocular surface changes following minimal vitreoretinal surgery in postmenopausal women patients with proliferative diabetic retinopathy (PDR). Methods Sixty-one women PDR patients (61 eyes) underwent vitreous microsurgery were recruited in this prospective study, including 31 postmenopausal women (PMW group) and 30 non-postmenopausal women (non-PMW group). The contralateral eyes were considered as the control group. Corneal fluorescein (FL) staining, tear break-up time (TBUT), Schirmer I test (SIT), central corneal sensitivity and ocular surface disease index (OSDI) were estimated. All tests were carried out 1 day preoperatively and 1 day, 10 days, 1 month and 3 months postoperatively. The student’st test or Mann-WhitneyU and ANOVA for repeat measurements test were used. Results Preoperatively, TBUT of surgery and non-surgery eyes in PMW were shorter than non-PMW (t=−2.115, −2.035;P＜0.05), but higher OSDI scores were found in PMW (t=2.482, 2.208;P＜0.05). TBUT reduction rate (Z=−2.771, −1.993;P＜0.05) and OSDI rising rate (Z=2.539, 2.157;P＜0.05) of surgery eyes in PMW were higher than non-PMW 1 day and 10 days postoperatively. The lower SIT of surgery eyes in PMW were observed at 1 day and 10 days (t=−2.403, −2.029;P＜0.05) after surgery. At 10 days after surgery, FL and OSDI scores of surgery eyes in non-PMW returned to preoperative level (Z=−0.447, −0.513;P＞0.05), but in PMW, the recovery process experienced 1 month (Z=−1.500, −0.853;P＞0.05). TBUT and SIT of surgery eyes in two groups both reached preoperative level at 1 month following surgery (Z=−0.715, −1.266, −1.531, −0.522;P＞0.05). Conclusions PMW with PDR had ocular surface dysfunction, which resulted in aggravated dry eye after minimal vitreoretinal surgery.
ObjectiveTo investigate the risk factors of postoperative vitreous hemorrhage after minimal vitrectomy without endotamponade for proliferative diabetic retinopathy (PDR).MethodsFrom June 2015 to June 2017, 103 eyes of 103 patients with PDR diagnosed and underwent minimalvitrectomy in Henan Provincial People's Hospital were enrolled in the study. There were 58 males and 45 females, with the average age of 58.37±10.14 years and diabetes duration of 8.7±7.2 years. Baseline systemic parameters including sex, age, diabetes duration, hypertension, HbA1c, creatinine, whether received anticoagulants, ocular parameters including whether combined with vitreous hemorrhage, whether finished panretinal photocoagulation (PRP), whether received treatment of anti-VEGF, whether combined with iris neovascularization (NVI), lens status preoperatively, whether hypotony postoperatively and intraoperative parameters including whether disc neovascularization (NVD) bleeding, whether fibrovascular membrane (FVM) residual, laser points, whether combined with cataract phacoemulsification were identified by multivariate logistic regression analysis.ResultsTwenty-nine of 103 eyes (28.15%) developed PVH in 1 day to 6 months after surgery, with self absorption of 18 eyes and reoperation of 11 eyes. Univariate analysis showed there were significant differences in age (t=2.124, P=0.036), anti-VEGF(χ2=7.105, P=0.008), NVD bleeding (χ2=10.158, P=0.001) and FVM residual(χ2=8.445, P=0.004) between patients with and without postoperative vitreous hemorrhage. Sex (χ2=0.021, P=0.884), diabetes duration (t=0.87, P=0.386), hypertension (χ2=2.004, P=0.157), HbA1c (t=1.211, P=0.229), creatinine (t=0.851, P=0.397), preoperative oral anticoagulants (χ2=0.985, P=0.321), preoperative vitreous hemorrhage (χ2=0.369, P=0.544), PRP (χ2=1.122, P=0.727), NVI (χ2=2.635, P=0.105), lens status (χ2=0.172, P=0.679), hypotony postoperatively (χ2=1.503, P=0.220), laser points (χ2=1.391, P=0.238) and combined phacoemulsification surgery (χ2=0.458, P=0.499) were not associated with PVH. Multivariate logistic regression analysis revealed the more PVH appeared in younger (OR=1.065, P=0.009) and NVD bleeding (OR=6.048, P=0.001) patients.ConclusionYounger age and NVD bleeding are the important risk factors for PVH after minimal vitrectomy without endotamponade in PDR.
Objective To observe the clinical effect of minimally invasive vitreoretinal (MIV) surgery combined with a modified suprachoroidal drainage surgery for retinal detachment associated with choroidal detachment (RRDCD). Methods A prospective clinical study. A total of 27 patients (27eyes) diagnosed as RRDCD were recruited in this study. There were 16 males and 11 females, with an average of (53.67±14.82) years. The mean intraocular pressure (IOP) was (8.2±2.1) mmHg (1 mmHg=0.133 kPa) and best corrected visual acuity (BCVA) of minimum resolution angle logarithm (logMAR) was 1.87±0.58. All subjects underwent 23G MIV combined a modified suprachoroidal drainage surgery, which 23G stab knife and 1 ml syringe needle were used for surgery. The visual outcome, IOP, rate of retinal reattachment and complications were comparatively analyzed preoperatively and postoperatively. Results At 1 day, 10 days, 1 month and 3 months after surgery, the average of logMAR BCVA were 1.62±0.67, 1.51±0.63, 1.39±0.54, 1.32±0.56 and the mean of IOP were (13.47±5.06), (14.43±4.09), (14.89±4.30), (15.38±3.37) mmHg, respectively. There were significant differences of logMAR BCVA and IOP between before and after surgery (F=6.19, 15.21; P＜0.05). Retinal reattachments were achieved in 27 eyes (100%) at 1 day and 10 days after surgery. At 1 month and 3 months after surgery, the rate of retinal reattachment were 88.89% (24 eyes) and 85.19% (23 eyes), respectively. No severe complications such as endophthalmitis and choroidal hemorrhage were found at follow-up visits. Conclusion MIV combined with a modified suprachoroidal drainage surgery is an effective and safe treatment for RRDCD, which can promote retina tear closure, improve visual acuity.