Systemic Risk Factors for Postoperative Vitreous Hemorrhage Following Diabetic Vitrectomy.

Yoon, June Taek; Kim, Chang Kook; Sohn, Jun Hong; Yoon, Young Hee

Original Article

Journal of the Korean Ophthalmological Society 2001;42(3):434-440.
Published online March 1, 2001.

Systemic Risk Factors for Postoperative Vitreous Hemorrhage Following Diabetic Vitrectomy.

June Taek Yoon, Chang Kook Kim, Jun Hong Sohn, Young Hee Yoon

Department of Ophthalmology, University of Ulsan, College of Medicine, Asan Medical Center.

당뇨유리체절제술 후 유리체 재출혈과 연관된 전신적 위험인자

김창국(Chang Kook Kim),윤준택(June Taek Yoon),손준홍(Jun Hong Sohn),윤영희(Young Hee Yoon)

Abstract

PURPOSE
To determine the incidence of and the systemic risk factors for postoperative vitreous hemor-rhage(PVH). METHOD: The records of 503 consecutive diabetic vitrectomy cases were reviewed. RESULT: Eighty-seven eyes(17.3%) had at least one episode of PVH. Sixty-five eyes(12.9%) had PVH within 3 months after vitrectomy, and the mean onset time of the first episode of PVH was about 13 weeks after vitrectomy. The mean follow-up period was 17.2 months in non-hemorrhage group, and 21.9 months in hemorrhage group. While 34 eyes(29.6%) had spontaneous absorption of blood, 42 eyes(36.5%) required air(or gas)-fluid exchange and 39 eyes(33.9%) vitreous cavity lavage. Using univariate analysis, the factors associated with increased incidence of PVH include type 1 diabetes mellitus(p=0.01), method of glycemia control(p=0.02), anemia(p=0.04), and hypercholesterolemia(p=0.005). Multivariate analysis revealed diabetic nephropathy(p=0.02) and hypercholesterolemia(p=0.01) were the risk factors. Five eyes(1.0%) lost light perception, 7 eyes(1.4%) had rhegmatogenous retinal detachment, and 11 eyes(2.2%) had neovascular glaucoma. CONCLUSION: Vitreous hemorrhage after diabetic vitrectomy occurred in the 17.3%, three quarters of them within 3 months. About one third had spontaneous clearing, and two-thirds required reoperation. Diabetic nephropathy and hypercholesterolemia were the systemic risk factors of vitreous hemorrhage after diabetic vitrectomy.

Key Words: Diabetic nephropathy;Diabetic vitrectomy;Hypercholesterolemia;Postoperative vitreous hemorrhage