Vitreous hemorrhage after the 25-gauge transconjunctival sutureless vitrectomy for proliferative diabetic retinopathy.
OBJECTIVE
To address the incidence, clinical course, and risk factors for postoperative vitreous hemorrhage (PVH) after a 25-gauge transconjunctival sutureless vitrectomy for proliferative diabetic retinopathy.


METHODS
A consecutive series of eyes underwent 25-gauge transconjunctival sutureless vitrectomies for proliferative diabetic retinopathy. The best-corrected visual acuities and intraocular pressures were measured, and the complications were prospectively evaluated 1 day, 1 week, 1 month, and 3 months postoperatively, then as needed.


RESULTS
The mean postoperative follow-up was 11.0 ± 6.3 months (range, 6-28 months). Of 93 eyes, 42 had PVH on Day 1 (immediate PVH) but the presence and degree of PVH did not affect visual recovery and only 4 eyes did not clear for 1 month (persistent PVH). Recurrent PVH occurred in 11 eyes. Eight eyes had hypotony on Day 1, and patients who experienced postoperative hypotony had an 11.20-fold increased risk of immediate PVH > Grade 2. In the cases that needed intravitreal tamponade, the risk of recurrent PVH was 3.03-fold higher.


CONCLUSIONS
After 25-gauge transconjunctival sutureless vitrectomies for proliferative diabetic retinopathy, postoperative hypotony and the need for tamponade increased the rates of immediate and recurrent PVH, respectively. Immediate PVH occurred in 45.2% of the patients but did not affect early visual recovery. A 25-gauge transconjunctival sutureless vitrectomy resulted in a favorable incidence of recurrent PVH (11.8%) during the first 6 months.
Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea.
Byung Joo
BJ
Lee
Hyeong Gon
HG
Yu
D000328:Adult; D000368:Aged; D003228:Conjunctiva; D003930:Diabetic Retinopathy / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007429:Intraocular Pressure / Q000502:physiology; D008297:Male; D008875:Middle Aged; D015814:Ocular Hypotension / Q000209:etiology; D011183:Postoperative Complications; D011446:Prospective Studies; D012008:Recurrence; D012307:Risk Factors; D013536:Suture Techniques; D014792:Visual Acuity / Q000502:physiology; D014821:Vitrectomy; D014823:Vitreous Hemorrhage / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery