Postoperative Visual Outcome In Patients Research Articles

Deep learning-based postoperative visual acuity prediction in idiopathic epiretinal membrane

BackgroundTo develop a deep learning (DL) model based on preoperative optical coherence tomography (OCT) training to automatically predict the 6-month postoperative visual outcomes in patients with idiopathic epiretinal membrane (iERM).MethodsIn this retrospective cohort study, a total of 442 eyes (5304 images in total) were enrolled for the development of the DL and multimodal deep fusion network (MDFN) models. All eyes were randomized into a training dataset with 265 eyes (60.0%), a validation dataset with 89 eyes (20.1%), and an internal testing dataset with the remaining 88 eyes (19.9%). The input variables for prediction consisted of macular OCT images and diverse clinical data. Inception-Resnet-v2 network was utilized to estimate the 6-month postoperative best-corrected visual acuity (BCVA). Concurrently, a regression model was developed using the clinical data and OCT parameters in the training data set for predicting postoperative BCVA. The reliability of the models was subsequently evaluated using the testing dataset.ResultsThe prediction DL algorithm exhibited a mean absolute error (MAE) of 0.070 logMAR and root mean square error (RMSE) of 0.11 logMAR in the testing dataset. The DL model demonstrated a robust promising performance with R2 = 0.80, notably superior to R2 = 0.49 of the regression model. The percentages of BCVA prediction errors within ± 0.20 logMAR amounted to 94.32% in the testing dataset.ConclusionsThe OCT-based DL model demonstrated sensitivity and accuracy in predicting postoperative BCVA in iERM patients. This innovative DL model exhibits substantial potential for integration into surgical planning protocols.

Visual Outcome and Complications in White Mature Cataracts after Phacoemulsification.

To identify risk factors and perioperative complications and assess postoperative visual outcome in patients of white mature cataracts undergoing phacoemulsification surgery. This cross-sectional study was conducted on 46 patients of white mature cataract undergoing phacoemulsification. Preoperatively, a detailed ocular examination was done, and anterior chamber depth (ACD) and lens thickness (LT) were measured on ultrasound biomicroscopy. Intraoperative and postoperative complications (on days 1, 7, and 30) and best-corrected visual acuity on postoperative day 30 were noted. The mean age of patients was 60.78 ± 9.001 years. The study group consisted of 41.3% of males and 58.7% of females. 8 (19.56%) cases encountered complications during phacoemulsification surgery. The intraoperative complications were capsulorhexis-related in 5 (10.86%) patients, posterior capsular rent in 2 (4.3%) patients, and 1 (2.17%) case had zonular dialysis. There was no difference in mean ACD and LT in cases who developed complications and those who underwent uneventful surgery (P > 0.05). The commonly observed postoperative complications on day 1 were corneal edema (41.3%), anterior chamber flare (45.65%), and cells (39.13%) which resolved with routine topical medications. All patients showed a significant reduction in postoperative intraocular pressure (P < 0.001). A total of 37 (80.43%) eyes regained vision between 6/6 and 6/9 postoperatively (P < 0.001). Phacoemulsification surgery is safe in white mature cataract that results in significant visual improvement. Common intraoperative complications are capsule related, while frequently encountered postoperative complications are corneal edema and anterior chamber reaction. Preoperative ACD and LT have no role in predicting intraoperative complications.

ROLE OF OPTICAL COHERENCE TOMOGRAPHY FOR PREDICTING POSTOPERATIVE VISUAL OUTCOMES AFTER REPAIR OF MACULA-OFF RHEGMATOGENOUS RETINAL DETACHMENT.

To identify any prognostic associations between preoperative optical coherence tomography findings and postoperative visual outcomes in patients with macula-off rhegmatogenous retinal detachment. A retrospective, single-center study of patients diagnosed with macula-off rhegmatogenous retinal detachment whom underwent surgical reattachment from 2012 to 2017. Optical coherence tomography images were analyzed by two retina surgeons. Outcome measures included "good" final vision (best-corrected visual acuity of 20/40 or better), "poor" final vision (best-corrected visual acuity of 20/200 or worse), and change in vision (worsened, improved, and improved ≥15 letters) at most recent follow-up. P values were calculated using t tests, analysis of variance, Wilcoxon rank-sum, or Kruskall-Wallis test. A total of 49 eyes were included. There was a significant difference in the mean preoperative central retinal thickness between patients who had good final vision and patients who did not (96 μm vs. 161 μm, P = 0.048). In addition, a worse preoperative best-corrected visual acuity and greater subretinal fluid height were associated with vision improvement (P < 0.001). Those with persistent ellipsoid zone disruption postoperatively were less likely to have good final vision (odds ratio = 0.217, 95% confidence interval: 0.057-0.828). A lower mean preoperative central retinal thickness is associated with good visual prognosis. Eyes with ellipsoid zone disruption postoperatively were less likely to have good final vision. Future studies should include a larger cohort of patients and more optical coherence tomography variables to address the inconsistencies in the current literature.

Prediction of Postoperative Visual Outcome in Patients with Idiopathic Epiretinal Membrane

Purpose: The aim of this study was to estimate the association between preoperative characteristics in subjects with idiopathic epiretinal membrane (ERM) and visual acuity improvement after vitrectomy and create an algorithm for predicting postoperative visual outcome. Methods: In a retrospective, cross-sectional study, we included adults with idiopathic ERM and excluded subjects with low-quality scans, other ocular conditions, and previous surgery except cataract surgery. Baseline characteristics were extracted from medical files, spectral-domain OCT, and OCT angiography. Visual improvement was expressed as a binary variable. Results: Fifty-four subjects were included in the study. Three months postoperatively, 30 subjects improved, 10 remained stable, and 14 deteriorated. Spearman correlation showed no correlation between variables and visual acuity improvement (<0.39). Reduced dimensionality showed that baseline visual acuity, lens status, foveal aspect, spherical equivalent, and 2 interactive variables including foveal aspect and lens status have the strongest effect on improvement. Five-fold logistic regression based on these variables provided a model with AUC 0.9 ± 0.06. Conclusion: No variable has a direct predictive role on visual acuity improvement; however, baseline visual acuity, lens status, foveal aspect and spherical equivalent, when combined, provide a predictive model that could serve as a tool for more informed decisions.

Predictive Factors for Long-Term Postoperative Visual Outcome in Patients with Macula-Off Rhegmatogenous Retinal Detachment Treated with Vitrectomy

Purpose: The purpose of this prospective study was to evaluate potential predictive factors of long-term postoperative outcomes in patients with macula-off rhegmatogenous retinal detachment (RRD) treated with pars plana vitrectomy (PPV). Methods: Participants in this study were 86 patients diagnosed with macula-off RRD, who underwent PPV. Demographic characteristics and preoperative characteristics of RRD were recorded, while best corrected visual acuity (BCVA) was measured preoperatively and at specific postoperative time points (6 weeks and 6, 12, and 24 months). In addition, spectral domain-optical coherence tomography (SD-OCT) characteristics at postoperative week 6 were assessed as potential factors affecting the long-term postoperative visual outcome 24 months after PPV for RRD. Results: Increasing age, duration of RD of more than 1 week, presence of proliferative vitreoretinopathy, increasing central retinal thickness, ellipsoid zone disruption, and external limiting membrane disruption were significantly associated with a worse BVCA. BCVA was not associated with gender, lens status, the location of breaks, the gas tamponade agent used in PPV, the presence of subretinal fluid, and intraretinal fluid. Conclusions: It is important to determine predictive factors for visual outcomes in order to inform patients about their prognosis and help in the decision-making process for patient management.

Usefulness of the Components of Full-Field Electroretinography to Predict Postoperative Visual Outcomes in Patients With Epiretinal Membranes.

PurposeTo confirm the predictors of postoperative visual outcomes by performing full-field electroretinography (ffERG) before surgery in patients with epiretinal membranes (ERMs).MethodsSixty-one eyes of patients with ERMs who underwent pars plana vitrectomy with membrane peeling were prospectively reviewed. Correlations between preoperative data (ffERG and optical coherence tomography) and postoperative best-corrected visual acuity (BCVA) were investigated. Receiver operating characteristic (ROC) curve analysis was performed to obtain cutoff values of the ffERG parameters predicting good visual outcome (final BCVA ≥ 20/30).ResultsPostoperative BCVA was significantly correlated with the implicit time and amplitude of the b-wave in light-adapted (LA) 3.0 electroretinography (ERG), with the amplitude difference between N1 and P1 in the LA 30-Hz flicker ERG, and with the sum of the amplitudes of OS1, OS2, and OS3 in dark-adapted (DA) oscillatory potential (OP) ERG (P < 0.01). The area under the ROC curve to predict good visual outcome was statistically significant for the four parameters (0.787, 0.815, 0.757, and 0.792, respectively).ConclusionsThe postoperative BCVA in patients with ERM was significantly correlated with the implicit time and amplitude of the b-wave in the LA 3.0 ERG, the amplitude difference between N1 and P1 in the LA 30-Hz flicker ERG, and the sum of the amplitudes of OS1, OS2, and OS3 in DA OP ERG of ffERG. It is thought that ffERG before surgery may help predict visual outcomes after surgery.Translational RelevanceIt was confirmed that the degree of retinal function in the ERM can predict BCVA after treatment.

Can the postoperative follow-up visit be deferred up to four weeks after an uneventful cataract surgery? - A randomized controlled trial.

Purpose:The aim of this study was to compare the postoperative visual outcome after a Day 0 examination in patients with two follow-ups, one between Day 3 to Day 7 and other between Day 25 to Day 30 to those with a single ophthalmic follow-up directly after 25–30 Days and to assess the safety of deferral of the first follow-up visit at 1 week.Methods:Randomized Controlled Trial was conducted at a tertiary eye care hospital, with 848 patients enrolled for the study. Patients meeting the inclusion criteria were selected. Their pre-operative and post-operative data was collected and the patients were divided into groups based on the type of cataract surgery and the postoperative follow-up protocol through randomization.Results:No significant difference was observed in the postoperative visual outcome in patients that underwent postoperative review at Day 3–7 and Day 25–30 as opposed to those that followed up directly at Day 25–30 after a mandatory Day 0 examination for all patients.Conclusion:In patients with no preexisting ocular or systemic comorbidity undergoing an uneventful cataract surgery, the postoperative follow-up visit can be safely deferred until 4 weeks, without any impact on the postoperative visual outcome, thereby conserving the available resources which can be deviated towards better eye care services.

Topical vs Peribulbar Anesthesia: Comparison of Anterior Chamber Depth and the Resultant Visual Outcome After Phacoemulsification.

PurposeTo compare anterior chamber depth and postoperative visual outcome in patients undergoing phacoemulsification under topical vs peribulbar anesthesia.Materials and MethodsProspective, randomized, comparative observational study.Sample size: 110 eyes with 55 eyes each. Group I: Patients undergoing phacoemulsification under topical anesthesia.Group II: Patients undergoing phacoemulsification under peribulbar anesthesia.Once patients were selected, baseline a standard ophthalmic examination was done including best-corrected visual acuity (BCVA), refraction, IOP by NCT, anterior segment evaluation with slit lamp biomicroscopy, keratometry, axial length, and ACD measurement by IOL master. Post-operatively, the patients were reviewed at day 1, week 1, week 6 for the same parameters.Statistics:Quantitative variables: Paired and unpaired t-test.Qualitative variables: Chi square test.A P-value of <0.05 was considered statistically significant.ResultsInter-group comparisons of post-operative change in ACD at 1-week post-op (P-value<0.001) and 6-week post-op (P-value<0.001) were statistically significant when compared to the pre-op values. The mean spherical equivalent in group I was 0.27±0.26 d and that in group II was 1±0.32 d at 1-week post-op. The mean spherical equivalent in group I was 0.23±0.20 d, while that in group II was 0.85±0.64 d at 6-week post-op. This difference was statistically significant both at 1-week post-op (P-value=0.002) and 6-week post-op (P-value<0.001).ConclusionPost-phacoemulsification, the ACD is more after peribulbar anesthesia as compared to topical anesthesia. Post-op refractive outcome is better with the use of topical anesthesia.

Large macular hole-Always a poor prognosis?

HintergrundAlter, präoperativer Visus und Makulaforamengröße gelten als prognostische Marker für das postoperative Ergebnis bei Patienten mit durchgreifendem Makulaforamen (MF).Ziel der ArbeitUm den postoperativen Verlauf nach i‑ILM Peeling (inverted-Flap ILM-Peeling) mit konventionellem ILM-Peeling (k-ILM) zu vergleichen, wurde eine retrospektive Beobachtungsstudie durchgeführt. Patienten mit i‑ILM Peeling hatten dabei präoperativ ein statistisch signifikant größeres Makulaforamen.Material und MethodenEs wurden 45 konsekutive Patienten mit durchgreifendem Makulaforamen (MF) in 2 Gruppen (i-ILM vs. k‑ILM) eingeteilt und auf Unterschiede im postoperativen Visus (BCVA) und der Netzhautmorphologie hin untersucht. Die Integrität der äußeren Netzhautschichten, äußere limitierende Membran (ELM), ellipsoide Zone (EZ) und äußere Photorezeptoraußensegmente (OS), wurde postoperativ mittels SD-OCT (Spectral-Domain-OCT) analysiert.ErgebnisseDie präoperative Apertur in der i‑ILM Gruppe war signifikant größer (i-ILM = 408,4 µm, SD = 157,5 µm; k‑ILM = 287,4 µm, SD = 104,9 µm; p = 0,01). Der Ausgangsvisus sowie der postoperative Visus nach 1 Monat waren in der Gruppe mit k‑ILM-Peeling signifikant besser (p = 0,03 und p = 0,001). Der postoperative Visus nach mindestens 6 Monaten zeigte keinen signifikanten Unterschied zwischen den beiden Gruppen (p = 0,24). Die ELM zeigte als erste der äußeren Netzhautschichten eine Re-Integrität in beiden Gruppen.SchlussfolgerungMithilfe der i‑ILM-Peeling-Technik erschien es in dieser konsekutiven Serie möglich zu sein, für Patienten mit großem durchgreifendem MF ein ähnliches postoperatives Visusergebnis zur erreichen wie für mittels k‑ILM-Peeling-Technik operierte Patienten mit kleinerem durchgreifendem MF.

Analysis of IOL power calculations and postoperative visual outcomes in patients who have undergone radial keratotomy and laser-assisted in situ keratomileusis

Analysis of IOL power calculations and postoperative visual outcomes in patients who have undergone radial keratotomy and laser-assisted in situ keratomileusis

Optical coherence tomography biomarkers as predictive factors for postoperative visual acuity in patients with epiretinal membrane treated with vitrectomy.

BACKGROUND:The purpose of this retrospective study was to evaluate potential predictive factors of postoperative visual outcome in patients with idiopathic epiretinal membrane (iERM), treated with pars plana vitrectomy (PPV).METHODS:Participants in the study were 46 patients diagnosed with iERM, who underwent PPV. Best-corrected visual acuity measurement and spectral domain-optical coherence tomography (OCT) were performed at baseline (preoperatively), and at months 6 and 12 postoperatively. Demographic characteristics and OCT parameters were assessed as potential predictive factors for postoperative visual outcome.RESULTS:Increasing age, retinal thickness, presence of disorganization of inner retinal layers, ellipsoid zone disruption, and presence of vitreomacular traction were found to be negatively associated with postoperative visual acuity. Gender, presence of subretinal fluid, cysts in the inner or outer nuclear layer, and hyperreflective foci were not found to affect visual acuity. There was statistically significant improvement in visual acuity and central retinal thickness between baseline and months 6 and 12 in the study sample.CONCLUSIONS:It is important to determine predictive factors for visual outcome, so as to inform patients about prognosis and help in the decision-making of patients' management.

Optical coherence tomography biomarkers for idiopathic epiretinal membrane after pars plana vitrectomy

AbstractIdiopathic epiretinal membrane (iERM) refers to fibroglial cellular proliferation at the vitreoretinal interface, above the internal limiting membrane (ILM) mainly at the macular area. The gold standard for the treatment of iERM is pars plana vitrectomy (PPV), which provides good anatomical and functional results. However, some patients did not exhibit visual acuity improvement after PPV for iERM. Advances in optical coherence tomography (OCT) have led to the introduction of new anatomic measures, such as precise evaluation of individual layers, qualitative and quantitative assessment of fluid distribution, inner retinal irregularity, ellipsoid zone integrity and disorganization of inner retinal layers (DRIL), which may predict more accurately the treatment success or failure after treatment. The purpose of this lecture is to investigate if characteristics identified on OCT may serve as biomarkers to predict postoperative visual outcomes in patients with iERM treated with PPV.

Preoperative visual evoked potential in the prediction of visual outcome after pituitary macroadenomas surgery.

The purpose of the present study is to investigate longitudinal changes in Visual evoked potential (VEP) parameters as an objective test after transsphenoidal surgery, its correlation with subjective tests and clinical value of VEP in the prediction of visual outcome. Fifty patients with pituitary macroadenoma who underwent surgical removal of the tumor recruited in this study. All the patients underwent ophthalmic examination, static automated perimetry (SAP), VEP and magnetic resonance imaging (MRI) preoperatively and 3months after surgery. Fifty patients with pituitary macroadenoma (size: 25.1 ± 9.9mm) were recruited in the study. Before surgery, the pattern of VEP showed a prolonged latency with reduced amplitude in eyes with abnormal visual acuity or abnormal visual field. The P100 wave latencies and amplitudes showed significant correlation with visual acuity and SAP scores. After surgery, visual acuity and visual field improvements were seen in 51% and 65.6% of eyes, respectively. Mean SAP and visual acuity scores increased significantly (p < 0.01), P100 wave latency declined and amplitude improved after surgery but not significantly. The mean age of patients, size of tumors and preoperative P100 wave latency were significantly lower in eyes with visual field and acuity improvement. VEP is a helpful quantitative and objective complementary test to visual acuity and SAP exams for assessing pre-operative visual abnormalities and post-operative visual outcome in patients with pituitary macroadenoma.

The Role of Disorganization of Retinal Inner Layers as Predictive Factor of Postoperative Outcome in Patients with Epiretinal Membrane

Purpose: The purpose of this retrospective study was to evaluate the disorganization of the retinal inner layers (DRIL) as a potential predictive factor of postoperative visual outcome in patients with idiopathic epiretinal membrane (iERM), treated with pars plana vitrectomy (PPV). Methods: Participants in the study were 46 consecutive patients diagnosed with iERM, who underwent PPV. Best corrected visual acuity (BCVA) measurement and spectral-domain optical coherence tomography (SD-OCT) were performed at baseline (preoperatively), and at months 3 and 6 postoperatively. DRIL and additional OCT parameters were assessed at 1-mm-wide foveal centered area. Results: DRIL was observed in 47.8% of patients at baseline. There was statistically significant improvement in BCVA and central retinal thickness (CRT) between baseline and months 6 and 12 in all patients. There was a statistically significant difference in BCVA and CRT change between patients with and without DRIL at months 6 and 12 compared to baseline, showing that there was a correlation between change in BCVA or CRT and baseline DRIL. Ellipsoid zone and external limiting membrane were intact in 91.3 and 95.7%, respectively, not affecting our results. Conclusions: Baseline DRIL has been shown to be predictive of postoperative visual outcome in patients with iERM, treated with PPV.

Ganglion cell‐inner plexiform layer thickness and visual improvement after vitrectomy for rhegmatogenous retinal detachment

PurposeTo evaluate the association of postoperative macular ganglion cell‐inner plexiform layer (GCIPL) thickness with postoperative visual outcomes in patients undergoing vitrectomy for macular–off rhegmatogenous retinal detachment (RRD) using spectral domain optical coherence tomography.MethodsData from 22 eyes with macular‐off RRD who were followed for more 6 months after successful pars plana vitrectomy were analyzed. Macular GCIPL thickness in eyes with RRD was compared with that of the normal contralateral eyes 6 months after surgery. The correlation between the interocular difference in GCIPL thickness and postoperative best corrected visual acuity (BCVA) was evaluated.ResultsPreoperative and postoperative central macular thickness were 538.09 ± 318.42 μm, 230.77 ± 34.69 μm. Mean GCIPL thickness was significantly decreased with time after surgery (3 vs. 6 months, p &lt; 0.01). Mean GCIPL thickness in eyes with RRD 6 months after surgery were 61.04 ± 12.04 μm and in the unaffected contralateral eyes were 73.67 ± 6.73 μm. The interocular difference in macular GCIP thickness was significantly correlated with postoperative BCVA. Among patients with intact photoreceptor layers, a greater decrease in GCIPL thickness was correlated with a worse postoperative BCVA (r = 0.629; p = 0.02). No significant correlation were identified between interocular macular GCIPL thickness difference and age (r = 0.629; p = 0.85), axial length (r = 0.874; p = 0.43).ConclusionsMacular GCIPL thickness decreased after vitrectomy to repair for RRD. The decrease in GCIPL thickness was significantly correlated with postoperative visual outcomes.

Postoperative Visual Outcome in Patients of Parasellar Meningiomas

Postoperative Visual Outcome in Patients of Parasellar Meningiomas

Ganglion Cell-Inner Plexiform Layer Thickness after Epiretinal Membrane Surgery: A Spectral-Domain Optical Coherence Tomography Study

To investigate postoperative macular ganglion cell-inner plexiform layer (GCIPL) thickness, determine the factors related to GCIPL thickness, and evaluate the association of GCIPL thickness with postoperative visual outcomes in patients with idiopathic epiretinal membrane (ERM). Retrospective, cohort study. Sixty-two patients with unilateral idiopathic ERM who were followed for ≥ 6 months after surgery. Ophthalmologic evaluations included best-corrected visual acuity (BCVA) assessment, spectral-domain optical coherence tomography, and macular visual field (VF) mean sensitivity (MS) as measured by Humphrey VF test. Macular GCIPL thickness in eyes with ERM was compared with that of the normal contralateral eyes 6 months after surgery. The correlation between the interocular difference in GCIPL thickness and postoperative visual outcome was evaluated. Postoperative macular GCIPL thickness, factors related to the interocular differences in GCIPL thickness, and correlations of GCIPL thickness with BCVA and macular VF MS 6 months after surgery. Macular GCIPL thickness was significantly lower in eyes with ERM 6 months after surgery (71.77 ± 10.21 μm) than in the unaffected contralateral eyes (81.69 ± 5.33 μm; P<0.001). Thirty-three subjects were followed for 1 year after surgery, and the macular GCIPL thickness in eyes with ERM did not significantly change between 6 and 12 months after surgery (71.77 ± 10.21 vs 70.64 ± 9.57 μm; P = 0.179). Preoperative central foveal thickness was the only factor significantly correlated with interocular differences in macular GCIPL thickness (r = 0.3677; P = 0.0033). Among patients with intact photoreceptor layers, a greater decrease in GCIPL thickness was correlated with a worse postoperative BCVA (r = 0.5209; P<0.0001) and a greater decrease in macular VF MS (r = -0.2845; P = 0.0390). Macular GCIPL thickness decreased after vitrectomy to remove an idiopathic ERM. The decrease in GCIPL thickness was significantly correlated with postoperative visual outcomes in patients with intact photoreceptor layers.

Electrorretinograma estandarizado en pacientes sometidos a vitrectomía por retinopatía diabética proliferativa avanzada

ObjectivePredicting postoperative visual outcome in patients with complex tractional retinal detachment and severe visual impairment. Material and methodsElectroretinogram was performed preoperatively to patients who un-derwent pars plana vitrectomy 23 gauge and phacoemulsification with lens implantation. ResultsNine eyes of nine patients were followed for six months. No patient achieved improvement in postoperative visual acuity. In three patients (33.4%) at six months, visual worsening occurred, six patients (66.66%) remained with preoperative visual acuity and postoperative at six months without changes. In all patients, responses were abolished in the standardized preoperative electroretinogram. ConclusionsElectroretinogram as preoperative examination in patients with diabetic traction retinal detachment and poor visual acuity predicts poor post-operative visual outcome.

Influence of Intraoperative Course on Visual Outcome after an RPE–Choroid Translocation

In a previous study, preoperative variables were correlated with postoperative visual outcome after the translocation of a free RPE-choroid graft. The present study was conducted to investigate whether the intraoperative course was an independent factor influencing visual outcome in these patients. This was a prospective interventional case series of 48 patients with exudative AMD treated with an RPE-choroid translocation. Preoperative and postoperative evaluation included ETDRS visual acuity (VA) and fixation testing by a masked examiner. Four critical surgical steps were evaluated, and the intraoperative course was graded from 0 (uncomplicated surgery) to 5 (most complicated surgery). The relationship between intraoperative course adjusted for preoperative delay/lesion composition and visual outcome at 3 months and 1 year after surgery was analyzed with multivariate analysis. The mean VA (logMAR) improved slightly from 0.99 before surgery to 1.00, 0.94, 0.89, and 0.91 after 3, 6, 9, and 12 months, respectively. Foveal fixation on the graft was present in 34 (71%) of the eyes at 1 year after surgery. The intraoperative course was statistically significantly associated with the DeltaVA (logMAR) at 3 months (P = 0.037) and at 1 year after surgery (P = 0.020) and if measured as gain or loss of > or =2 ETDRS-lines (odds ratio [OR] 1.8, 95% confidence interval [CI] 1.7 to 2.8, P = 0.027) and > or =3 ETDRS lines (OR, 2.2, 95% CI 1.9-3.5, P = 0.003); better surgery was associated with visual gain whereas eventful surgery was associated with visual loss. The intraoperative course adjusted for preoperative variables had a statistically significant influence on postoperative visual outcomes in patients treated with a free RPE-choroid translocation. Refining the surgery could improve results.

Preoperative Electroretinogram and PostoperativeVisual Outcome in Patients with Diabetic Vitreous Hemorrhage

Purpose: To determine whether the single-flash electroretinogram (ERG) can predict the postoperative outcome in diabetic cases where massive vitreous hemorrhage precludes fundus observation. Methods: Eighty-five diabetic patients (105 eyes) who underwent vitrectomy due to dense vitreous hemorrhage were studied retrospectively. Eyes with postoperative complications were excluded. Preoperative ERGs (mixed cone-rod ERG with maximum flash intensity) were classified as: Group A, the b-wave/a-wave ratio (b/a ratio) was ≥1.0 and the oscillatory potentials (OPs) were clearly recordable (22 eyes); Group B, the b/a ratio was ≥1.0 and the OPs were markedly reduced (33 eyes); and Group C, the b/a ratio was <1.0 (50 eyes). Results: The postoperative visual acuity in Group C (hand motion to 1.5) was significantly worse than in Group A (0.4–.2) ( P<.01) or Group B (0.08–1.0) ( P<.01). Thick preretinal membrane causing retinal traction around the optic disc was found intraoperatively in 1 eye (4.5%) in Group A, 9 eyes (27.3%) in Group B, and 28 eyes (56.0%) in Group C ( P = .0132). Conclusion: Our findings suggested that the configuration of the single-flash ERG can provide important preoperative information for a functional prognosis following vitrectomy in diabetic patients with vitreous hemorrhage.