[Effects of vitrectomy as a treatment for proliferative diabetic retinopathy in young patients].

ABSTRACT

PURPOSE: To investigate the effects of vitrectomy as a treatment for the proliferative diabetic retinopathy (PDR) in patients under 40 years old. METHODS: Sixty eyes of 37 patients under 40 years old with PDR who had undergone vitrectomy for the first time in Juntendo University Urayasu Hospital were included in this study. Preoperative condition, operation methods, visual acuity after operation and complications both during or after operation, especially neovascular glaucoma (NVG), were reviewed retrospectively. RESULTS: Visual acuity improved in 43 eyes (72%) by more than 0.2 logMAR compared to that before the operation, remained stable in 4 eyes (6%) and deteriorated in 13 eyes (22%) by more than 0.2 logMAR compared to that before operation. Optic atrophy and phthisis caused by NVG constituted 69% of the causes of complicated final visual acuity. Male patients and patients who had both hypertension and proteinuria had significantly higher prevalence of NVG after vitrectomy (p < 0.05), and patients who retained their lens after the first vitrectomy had a significantly lower prevalence of NVG after the operation (p < 0.05). CONCLUSIONS: In young PDR patients under 40 years old, postoperative NVG was the main reason for severe visual impairment. Multifactorial causes, both general and ophthalmic seem to be implicated in the onset and progression of NVG derived from PDR.