| Aim: To evaluate the efficacy and safety of vitrectomy for young proliferative diabetic retinopathy(PDR),and to report the clinical features of young PDR.Methods: A retrospective review analysis of younger than 40 years PDR patients who underwent vitrectomy for PDR between 2010 and 2018.Older than 40 years who received PPV for PDR during the same period were randomly retrospective selected as the control group.The data were collected included preoperative systemic data,surgical indication,intraoperative ocular conditions,the best-corrected visual acuity(BCVA),the intraocular pressure(IOP),anatomic success,and postoperative complications.Postoperative complications included the rate of neovascular glaucoma(NVG),recurrent retinal detachment(RCRD),postoperative vitreous hemorrhage(PVH),epiretinal macular membrane(ERM)and hyphema etc.Statistical analysis was performed using SPSS software version 22.0 and p values <0.05 were taken as significant,the figure was made by GraphPad Prism version 7.0.Results:1.There were 44 eyes(29 patients)in the study group and 52 eyes(32 patients)in the control group were followed up for at least 12 months.The average age at surgery was 34.59±4.18 years and 54.98±8.19 years,respectively(p=0.000<0.05);the mean duration from the diagnosis of diabetes mellitus(DM)to operation was 4.50±4.31 years and 14.24±7.46 years,respectively(p=0.000<0.05).2.The incidence of end-stage renal disease was higher in the study group(p=0.038),diastolic blood pressure was also significantly higher in the study group(p=0.003),but the incidence of cerebral infarction in the control group was higher than that in the study group(p= 0.000<0.05).3.The surgical indications of proliferative traction(stage V)and traction retinal detachment(VI stage)were significantly higher proportions in the study group and vitreous hemorrhage(IV stage)was more common in patients older than 40 years(p=0.003<0.05).4.The operation time in the study group was significantly longer than that in the control group(p=0.049<0.05),and the rate of phacovitrectomy in the study group wassignificantly lower than that in the control group(p=0.000<0.05).There was no significant difference in the comparison of intraoperative fillers between the two groups(p=0.463>0.05).5.The postoperative BCVA of the two groups were significantly higher than preoperative BCVA(p < 0.05 for all).However,no significant difference in BCVA was noted between the two groups at any time point(p > 0.05 for all).6.There was no significant difference in intraocular pressure(IOP)between the two groups except one month after operation(p=0.02<0.05).7.The success rate of retinal anatomic reduction in the study group and the control group was 93.2% and 100% respectively,the difference was not significant(p >0.05).8.Finally,the rate of postoperative NVG in the study group was higher than control group,but there was no significant difference in the other postoperative complications between the two groups.Conclusions:1.The development time of younger DM to PDR requiring surgical treatment was significantly shorter than elder DM.2.The general condition of young PDR was worse than elder PDR.3.The surgical indications of study group were mainly about proliferative traction(stage V)and traction retinal detachment(VI stage),and vitreous hemorrhage(IV stage)was more common in patients older than 40 years.4.The operation time of the young PDR was significantly longer than elder PDR,and the rate of phacovitrectomy was significantly lower than that of the elder PDR.5.The risk of postoperative NVG in young PDR patients was significantly higher than that in elderly PDR,patients with other complications.6.Vitrectomy is not only an effective and safe treatment for older PDR patients,but also an effective and safe treatment for younger PDR patients. |
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