Analysis On The Risk Factors Of Pars Plana Vitrectomy Surgery On Diabetic Retinopathy In Patients With Type â…  And Type â…¡ Diabetes

Objective:Through the analysis of the occurrence of Intraocular Pressure Elevation、Vitreous Re-hemorrhage and Retinal Detachment after pars plana vitrectomy(PPV) surgery on PDR patients with type I and type II diabetes, the risk factors were observed and compared between the 2 types. Methods:Retrospectively analysed the clinical data of 377 patients with VI PDR who had been had pars plana vitrectomy(PPV) surgery in our hospital(the Second Hospital of Jilin University) from October 2009 to June 2016. Based on the types of DM, patients were divided into 2 groups: Group A: Type I Diabetic Retinopathy. Group B: Type II Diabetic Rretinopathy. Analyse sex, age, BMI, duration of disease, smoking, duration of diabetes, glycosylated hemoglobin, urine protein, intraocular operation history, and other related factors of the 377 patients with SPSS19.0. Results:1.General information analysis: sex, age, eyes, duration of disease, duration of diabetes, BMI, urine protein, glycosylated hemoglobin has no significant difference between the two groups. But for smoking, Group B was significantly higher than Group A(P<0.05).2.Analysis of early postoperative Intraocular Pressure Elevation: there were 190 cases come up intraocular pressure elevation after operation in 5 days, of which Group A was significantly lower than Group B(P<0.05).2.1 Analysis of the influence of different factors on early postoperative intraocular pressure elevation between the two groups:(1)The duration of diabetes, smoking, intraocular operation history had no significant effect on the occurrence of postoperative Intraocular Pressure Elevation on group A.(2)Smoking, intraocular operation history had significant effect on the occurrence of postoperative Intraocular Pressure Elevation on group B(P<0.05).(3)For Group A, no difference was showed between the comparison of patients who underwent part photocogulation and panretinal photocogulation, without photocogulation on Intraocular Pressure Elevation,.as for the compare between patients who underwent panretinal photocogulation and without photocogulation, the incidence of Intraocular Pressure Elevation present significant difference(P<0.05).(4)For Group B, Intraocular Pressure Elevation was more inclined to occur in patients who underwent panretinal photocogulation, than the one who underwent part photocogulation or without photocogulation(P<0.05).(5)For Group A, no difference was showed between the comparison of C3F8 filled group and silicon oil filled group, irrigation filled group on Intraocular Pressure Elevation,.as for the compare between irrigation filled group and silicon oil filled group, the incidence of Intraocular Pressure Elevation present significant difference(P < 0.05).(6)For Group B, no difference was showed between the comparison of C3F8 filled group and silicon oil filled group, irrigation filled group on Intraocular Pressure Elevation,.as for the compare between irrigation filled group and silicon oil filled group, the incidence of Intraocular Pressure Elevation present significant difference(P<0.05).2.2 Comparison of the differences between the two groups on the occurrence of postoperative Intraocular Pressure Elevation :(1)Group A has a higher occurrence rate than Group B on non smokers, without photocogulation patients.(2)Group B has a higher occurrence rate than Group A on silicon oil filled group.3.Analysis of the Vitreous re-hemorrhage: Vitreous re-hemorrhage came up in 34 cases, of which group A was significantly more than group B(P<0.05).3.1 Analysis of the influence of different factors on Vitreous re-hemorrhage between the two groups:(1)The urine protein had no significant effect on the occurrence of Vitreous re-hemorrhage in group A.(2)Intraocular operation history had significant effect on the occurrence of Vitreous re-hemorrhage in group A(P<0.05).(3)The urine protein, intraocular operation history had significant effect on the occurrence of Vitreous re-hemorrhage in group B(P<0.05).(4)For Group A, no difference was showed in the comparison of C3F8 filled group and silicon oil filled group, irrigation filled group on Vitreous re-hemorrhage,.as for the compare between irrigation filled group and silicon oil filled group, the incidence of Vitreous re-hemorrhage present significant difference(P<0.05).(5)For Group B, no difference was showed between the comparison of C3F8 filled group and irrigation filled group on Vitreous re-hemorrhage, Vitreous re-hemorrhage was more inclined to occur in patients who had silicon oil filled(P<0.05).3.2 Comparison of the differences between the two groups on the occurrence of Vitreous re-hemorrhage: Group A has a higher occurrence rate than Group B on irrigation filled patients(P<0.05).4.Analysis of the Retinal Detachment after pars plana vitrectomy: Vitreous re-hemorrhage: Retinal Detachment came up in 13 cases after pars plana vitrectomy, of which group A was significantly less than group B(P>0.05).5.Analysis of Vitreous re-hemorrhage/Retinal Detachment after pars plana vitrectomy: Re-hemorrhage/Retinal Detachment came up in 42 cases after pars plana vitrectomy, of which group A was significantly more than group B(P>0.05). Conclusion:1. Without retinal photocogulation and irrigation filled were risk factors of type I PDR on early postoperative intraocular pressure elevation.Smoking, intraocular operation history, retinal photocogulation and silicon oil filled were risk factors of type II PDR on early postoperative intraocular pressure elevation.2. Irrigation filled was risk factor of type I PDR on Vitreous re-hemorrhage. Intraocular operation history, combine Diabetic Nephropathy were risk factors of type II PDR on Vitreous re-hemorrhage.3. Type II PDR has a higher occurrence rate on early postoperative Intraocular Pressure Elevation than Type I PDR on silicon oil filled patients and retino photocogulation patients.4. Type I PDR has a higher occurrence rate on Vitreous re-hemorrhage than Type II PDR on irrigation filled patients.