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Risk factors for requirement of filtration surgery after vitrectomy in patients with proliferative diabetic retinopathy

机译：增生性糖尿病视网膜病变患者玻璃体切除术后需进行滤过手术的危险因素

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Purpose: We retrospectively reviewed patients with postoperative neovascular glaucoma (NVG) after vitrectomy for proliferative diabetic retinopathy to investigate how variables assessed before, during, and after vitrectomy are associated with the requirement for filtration surgery. Patients and methods: The subjects in this retrospective, observational, comparative study were 55 consecutive patients (61 eyes) who underwent vitrectomy for proliferative diabetic retinopathy at Toho University Sakura Medical Center between December 2011 and November 2016, were followed up for at least 6 months after surgery, and developed NVG within 2 years after surgery. They comprised 44 men and 11 women of mean age 52.4±9.1 years, who were followed up for a mean 7.1±6.1 months. We collected data on the following 16 variables: sex, age, history of panretinal photocoagulation completed within 3 months before vitrectomy, presence/absence of a lens, obvious iris/angle neovascularization, tractional retinal detachment, diabetic macular edema, vitreous hemorrhage, visual acuity and intraocular pressure before vitrectomy and at the onset of NVG, glycated hemoglobin, fasting blood glucose, estimated glomerular filtration rate, and use of intraoperative gas tamponade. Results: Logistic regression analysis with the backward elimination method identified preoperative fasting hyperglycemia ( P =0.08), high intraocular pressure at the onset of NVG ( P =0.04), and use of gas tamponade during vitrectomy ( P =0.008) to be significant risk factors for requirement of filtration surgery. Conclusion: Preoperative fasting hyperglycemia, high intraocular pressure at the onset of NVG, and use of gas tamponade during vitrectomy predispose patients to require filtration surgery in the event of postoperative NVG.
机译：目的：我们回顾性分析了玻璃体切除术后增生性糖尿病性视网膜病变的术后新生血管性青光眼（NVG）患者，以研究玻璃体切除术之前，期间和之后评估的变量如何与滤过手术的需求相关。患者和方法：这项回顾性，观察性比较研究的对象是2011年12月至2016年11月在东邦大学樱花医学中心接受玻璃体切除术治疗增生性糖尿病视网膜病变的55例患者（61眼），随访了至少6个月手术后，并在手术后2年内发展了NVG。他们包括平均年龄为52.4±9.1岁的44名男性和11名女性，平均随访时间为7.1±6.1个月。我们收集了以下16个变量的数据：性别，年龄，玻璃体切除术前3个月内完成的视网膜光凝史，是否存在晶状体，虹膜/角膜新生血管明显，视网膜脱离，糖尿病性黄斑水肿，玻璃体出血，视力玻璃体切除术之前和NVG发作时的眼压，糖化血红蛋白，空腹血糖，估计的肾小球滤过率以及术中使用的气体压塞。结果：采用后向消除方法进行逻辑回归分析，发现术前禁食高血糖（P = 0.08），NVG发作时眼内压高（P = 0.04）以及在玻璃体切除术中使用气填塞（P = 0.008）具有重大风险。过滤手术要求的因素。结论：术前禁食高血糖，NVG发作时眼内压高以及在玻璃体切除术中使用气填塞易使患者在术后NVG时需要进行滤过手术。

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