The visual prognostic factors in vitreoretinal surgery for diabetic tractional retinal detachment

Abstract

Objective To evaluate the visual prognostic factors in vitreoretinal surgery for diabetic tractional retinal detachment (DTRD). Methods 102 eyes of 86 consecutive patients with DTRD underwent vitreoretinal surgery were analyzed retrospectively. All cases diagnosed via indirect ophthalmoscope and B ultrasonic scan after mydriasis. Follow-up duration varied from 12 to 56 months (mean: 23 months). Best corrected visual acuity (BCVA) and anatomic success were observed postoperatively. The patients were divided into visual acuity improved group and didn't improved group. T-test, Chi-square test and Multivariate Logistic regression analysis were performed to predict the prognosis of visual acuity. Results After primary vitreoretinal surgery, 87 eyes (85.3%) were anatomically reattached, 15 eyes (14.71%) needed reoperation because of the recurrence of retinal detachment (RD). Postoperative BCVA improved and better than 0. 05 in 49 eyes (48.04%), reduced or increased but less than 0. 05 in 53 eyes (51.96%). Comparing natural factors between these two groups, only combined cataract surgery and optic nerve atrophy were significant different (χ~2= 5.266, 9.274; P =0.022, 0.002). Among post-operative complications only the RD recurrence was significant different (χ~2= 12. 059, P = 0. 000). Multivariate Logistic regression revealed recurrence of RD and optic nerve atrophy were two independent risk factors in the final BCVA (P = 0. 003, 0. 041 ; OR = 33. 518,4. 079). Preoperative PRP was identified as the only protecting variable in the final BCVA(P=0. 034,OR=0. 270). Conclusion This study revealed recurrence of RD and optic nerve atrophy were two independent risk factors in final BCVA of DTRD patients. Key words: Diabetic retinopathy/complications;  Diabetic retinopathy/therapy;  Retinal detachment/therapy;  Vitrectomy/methods