The Clinic Analysis Of Vitreous Hemorrhage After Laser Photocoagulation For Diabetic Retinopathy

Objective:To analyze the clinic characteristic of vitreous hemorrhage after laser photocoagulation for diabetic retinopathy(DR), and to discuss the treatment effect of vitreoretinal surgery for vitreous hemorrhage after laser photocoagulation.Patients and Methods:949 eyes of 598 DR patients after laser photocoagulation were analyzed retrospectively from 1996 to 2005, including 33 eyes of 19 type 1 diabetic patients and 916 eyes of 579 type 2 diabetic patients.62 eyes of 59 patients had severe vitreous hemorrhage after laser photocoagulation,including 37 eyes of 35 female patients and 25 eyes of 24 male patients.There were 7 eyes of 5 type 1 diabetic patients and 55 eyes of 54 type 2 diabetic patients.The age ranged from 34 to 69 years(mean 51 years).The course of DR ranged from 5 to 25 years(mean 16 years)。The course of vitreous hemorrhage ranged from 2 to 13 months(mean 4.2 months).All eyes had undergone vitreoretinal surgery with intraoperative laser photocoagulation.Median follow-up was 18 months(range of 6-38 months).Results:The incidence rate of severe vitreous hemorrhage after laser photocoagulation was 21%in the type 1 diabetic patients,and the incidence rate of severe vitreous hemorrhage after laser photocoagulation was 6%in the type 2 diabetic patients.The incidence rate of severe vitreous hemorrhage after laser photocoagulation in the type 1 diabetic patients was significantly higher than that in the type 2 diabetic patients (P＜0.05).All patients had undergone vitreoretinal surgery.The visual acuity after vitreoretinal surgery was better than 0.1 in 51 eyes(82.26%), and better than 0.02 in 62 eyes(100%).The visual acuity after vitreoretinal surgery was better than 0.5 in 9 eyes,and the proportion was higher in the group of vitreous hemorrhage 6months.The complications included vitreous hemorrhage in 1 eye(1.61%),complicated cataract in 23 eyes (50%),temporary ocular hypertension in 6 eyes(9.68%),corneal edema in 6 eyes(9.68%),and uveitis in 4 eyes(6.45%),and retinal tear in 5 eyes(8.07%).Conclusions:Severe vitreous hemorrhage occurred in patients with DR stageⅢupwards after laser photocoagulation sometimes.The incidence rate of severe vitreous hemorrhage after laser photocoagulation in the type 1 diabetic patients was significantly higher than that in the type 2 diabetic patients.These patients had a distinct improvement in visual acuity after vitreoretinal surgery without severe complications.