Clinical Analysis For Risk Factors Influencing The Early High Intraocular Pressure After Vitrectomy For Proliferative Diabetic Retinopathy

Objective:To discuss the risk factors in postoperative high intraocular pressure(IOP)of vitrectomy for the proliferative diabetic retinopathy(PDR),in order to control high IOP effectively,so as to improve prognosis of vitrectomy.Methods:A retrospective analysis was made of 152 cases(152 eyes)of PDR patients who underwent vitrectomy in the first inpatient department of ophthalmology ward of The fourth people’s hospital of Shenyang from October 2015 to July 2016.We recorded the basic information of the patient such as PDR classification,DM course,history of anti-VEGF injections and other intraocular surgery,surgical information such as operation duration,intraoperative retinal laser photocoagulation and vitreous cavity tamponade,postoperative information such as intraocular hemorrhage,inflammatory reaction in the anterior chamber,and the IOP in the early period.SPSS 22.0 statistical software package was employed to analyze the data.Results:1.There were 69 cases of high IOP within one week after vitrectomy,and the incidence of high IOP was 45.39%.High IOP mainly occurred within 24 hours after vitrectomy,and all occurred within 3 days after vitrectomy.2.Gender and age had little significant effect on the occurrence of high IOP in early postoperative period(P=0.358;P=0.396).However,it can be seen that the incidence of high IOP elevated gradually with the increase of age.3.The incidence of postoperative high IOP in PDR Ⅵ group was higher than that in PDR Ⅴ group(P=0.021).4.There was no significant correlation between the course of DM and the occurrence of early postoperative high IOP(P=0.147).5.High IOP was more likely to occur in patients with a history of anti-VEGF injections and other previous intraocular surgery than those without surgical history(P=0.026).6.The longer the operation duration was,the higher incidence of high IOP was.7.In the total retinal laser photocoagulation group,high IOP was more likely to occur than in the partial retinal laser photocoagulation group(P=0.031).8.In the aspect of sorts of intraocular tamponade,the incidences of early IOP elevation in silicone oil group and of perfluoropropane group were higher than that in perfusion fluid group.However,there was no significant difference in the incidence of high IOP between silicone oil group and perfluoropropane group(P=0.204).9.High postoperative IOP was more likely to occur in the intraocular hemorrhage group than in the non-hemorrhage group(P=0.008).10.The incidence of high IOP was higher in patients with obvious anterior chamber inflammation after operation(P=0.022).11.Logistics multiple regression analysis showed that operative duration,vitreous cavity tamponade,postoperative intraocular hemorrhage,postoperative anterior chamber inflammation were independent risk factors for the occurrence of high postoperative IOP in the early period after vitrectomy.Conclusion:1.The incidence of early high postoperative IOP after PDR with vitrectomy is relatively high,and it is the result of a variety of factors.2.Operation duration,vitreous cavity tamponade,postoperative intraocular hemorrhage and postoperative anterior chamber inflammation were independent risk factors of early high IOP after vitrectomy.