Study On Related Factors Affecting Visual Acuity Recovery After Vitrectomy For Proliferative Diabetic Retinopathy

Objective: To analyze the influencing factors of short-term visual recovery after vitrectomy for proliferative diabetic retinopathy(PDR).Methods:This was a retrospective study.The data of consecutive PDR patients treated with 23 G vitrectomy and follow-up time ≥3 months in Shenyang He Eye Hospital from January 2018 to December 2018 were collected for analysis.Eyes with previous ocular trauma,glaucoma,congenital eye disease,hereditary eye disease,or age related macular degeneration were excluded.Patients’ age,gender,residence(urban/rural),duration of diabetes,insulin injections,oral hypoglycemic drugs,glycosylated hemoglobin values,hypertension,previous retinal photocoagulation,duration time of vision loss,preoperative best corrected visual acuity(BCVA),preoperative intraocular pressure,vitreous status,tractional retinal detachment,neovascularization of iris/anterior chamber angle,lens surgery combined(without lens extraction,with lens extraction,intraocular lens implantation combined),operation time,glass body cavity state(perfusion fluid /Silicone oil/inert gas),anti-VEGF therapy(no/preoperative/intraoperative).Multiple linear regression method were used to analyse the correlation of the factors above listed and Log MAR BCVA at 3 months after surgery.Results: Total 246 eyes of 246 patients were included,120 males and 126 females.The mean age was 54.23±10.9 years.The mean BCVA(Snellen vision)at 3 months after surgery was 0.2969±0.25363,with 111 cases above 0.3(including 0.3),95 cases between 0.02 and 0.3(including 0.02),and 40 cases below 0.02.Preoperative Log MAR BCVA(β=0.314 P<0.001),surgical operation time(β=0.005 P=0.009),duration time of diabetes(β=0.011 P=0.048)were positively correlated with Log MAR BCVA at 3 months after surgery.Compared to aphakia,intraoperative lens retention(β=-0.690 P<0.001)and lens extraction combined with intraocular lens implantation(β=-0.742 P<0.001)were a negative correlation with Log MAR BCVA at 3 months after surgery.There was no significant correlation between gender,age,place of residence,insulin injections,oral hypoglycemic drugs,hypertension,vitreous status,tractional retinal detachment,duration time of vision loss,pre-operative/intraoperative anti-VEGF treatment and Log MAR BCVA at 3 months after surgery.Conclusion: In the treatment of PDR by vitrectomy,better preoperative BCVA,less operation duration and shorter duration of diabetes would predict better vision acuity at short term follow up.