title: Long-term results, prognostic factors and cataract surgery after diabetic vitrectomy: a 10-year follow-up study.
abstract: OBJECTIVE
  To report long-term results, prognostic factors and cataract surgery after diabetic vitrectomy.
  
  
  METHODS
  Retrospective review of patient files from a large diabetes centre between 1996 and 2010. Surgical history was obtained from the Danish National Patient Register. Follow-up intervals were 3 months and 1, 3, 5 and 10 years after surgery.
  
  
  RESULTS
  In total, 167 patients had diabetic vitrectomy indicated for non-clearing vitreous haemorrhage (47%) and tractional retinal detachment (53%). The proportion of patients with visual acuity ≥0.3 increased from 29% before surgery to 60% after 3 months (p < 0.001, chi-square test). Median visual acuity increased from 0.06 before surgery to 0.3 after 3 months (p < 0.001, paired signed-rank test) and 0.4 after 1 year (p = 0.009) before stabilizing. No significant long-term prognostic factors were identified for non-clearing vitreous haemorrhage patients. For tractional retinal detachment patients, use of silicone oil was associated with low vision (visual acuity<0.3) after 3 months and 1, 3 and 5 years (all odds ratios >4 and p-values ≤ 0.03, logistic regression). Of the 134 patients who were phakic after surgery, 43% and 29% were phakic after 5 and 10 years, respectively. Use of silicone oil increased the risk of cataract surgery (p = 0.009, log-rank test).
  
  
  CONCLUSIONS
  Most diabetic vitrectomy patients stand to gain visual acuity ≥0.3 after surgery and a stable long-term visual acuity after 1 year. The only consistent long-term predictor of low vision after surgery is use of silicone oil for endotamponade. About 2/3 of phakic patients will subsequently have cataract surgery the first 10 years after diabetic vitrectomy.
authors.affiliation: Department of Ophthalmology, Glostrup University Hospital, Copenhagen, Denmark.
authors.forename: Christoffer
authors.initials: C
authors.lastname: Ostri
authors.forename: Anja
authors.initials: A
authors.lastname: Lux
authors.forename: Henrik
authors.initials: H
authors.lastname: Lund-Andersen
authors.forename: Morten
authors.initials: M
authors.lastname: la Cour
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002387:Cataract Extraction / Q000706:statistics & numerical data*; D003922:Diabetes Mellitus, Type 1 / Q000150:complications; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D003930:Diabetic Retinopathy / Q000503:physiopathology / Q000601:surgery*; D058450:Endotamponade; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012163:Retinal Detachment / Q000503:physiopathology / Q000601:surgery*; D012189:Retrospective Studies; D012827:Silicone Oils; D014786:Vision Disorders / Q000209:etiology / Q000601:surgery; D014792:Visual Acuity / Q000502:physiology*; D014821:Vitrectomy; D014823:Vitreous Hemorrhage / Q000503:physiopathology / Q000601:surgery*; D055815:Young Adult
chemical_list: D012827:Silicone Oils
keywords: cataract surgery; diabetes; diabetic vitrectomy; long-term results; prognostic factors; results; silicone oil; visual acuity; vitrectomy