Complications Analysis On Vitrectomy Combined With Different Tamponades For Diabetic Vitreous Hemorrhage

Objective:To evaluate and observe the efficacy of silicone oil(SO),perfluoropropane (C3F8) and balanced salt solution(BSS) that can be used as tamponade during vitrectomy to treat vitreous hemorrhage(VH) secondary to proliferative diabetic retinopathy (PDR). Methods:Studied retrospectively on 74 eyes of 60 patients who underwent vitrectomy surgery with diabetic VH in our hospital during Jun.2008 and Jun.2014.Based on repeated prior examines on fundus details,vitrectomy tamponades were chosen as following rules:SO has been chosen on the patients with mass active hemorrhage in the surgery,extensive range of VH or the high risk of hemorrhage after surgery.C3F8 has been chosen on the patients with preoperative retinal tear or iatrogenic retinal tear which photocoagulation was incapable,the dissociated vessel endings,or mild active hemorrhage with the uncertain bleeding point during operation.BSS has been chosen on the patients without breaks or active hemorrhage,otherwise the patients with retinal tears or the bleeding spots which can be cured by photocoagulation.All the patients had been followed up at least 3 months.Depending on different tamponades,the patients were in three groups and contrasted as visual acuity,intraocular pressure (1OP) and complications respectively. Results:The risk factors was statistically different and significant at 0.05 for the three groups.Eyesight:47.30% of patients’visual function was improved,the most obvious one was BSS group by the rate of 60.47%,the C3F8 in the second place and its recovery rate was 33.33%,the less recovered one was SO,the rate was 27.27%.The preoperative visual function was in contrast to the postoperative(P<0.05).Afterwards,we compared the visual acuity before and after surgery about each groups,the difference were in the SO and BSS,and the difference in the rest comparisons were not significant. IOP:Postoperative IOP elevation occurred in 31.08% of participates,thereinto the most obvious one was C3F8 group by the rate of 66.67%,the rate of the SO group was 31.82%,BSS was the lowest(23.26%).The comparison of IOP between before and after operation was noticeable difference(p< 0.05).Apart from the BSS group,the IOP between preoperation and postoperation in SO as well as C3F8were elevated strikingly(P<0.05). Complications:The occurence rate of complications after surgery was 47.30%,the SO group was 50.00%,the C3F8 group was 55.56%,the BSS group was 44.19%. Conclusions:Vitrectomy is a safe and effective treatment that can help patients who have diabetic VH obtain better visual improvement.BSS can be used in the patients with slight state of illness.While confronted with serious condition,the tamponades must be used.We found that SO was preceded than C3F8 in complications and postoperative IOP.But it was premature to conclude,and it must be improved in the future work.