Improved outcome after primary vitrectomy in diabetic patients treated with statins.
OBJECTIVE
To evaluate the effect of preoperative statin treatment on the outcome of primary vitrectomy in type 1 and 2 diabetic patients.


METHODS
In this open, observational institutional study, a total of 192 eyes of 171 type 1 and 2 adult diabetic patients admitted for primary vitrectomy for management of sight-threatening forms of diabetic retinopathy were divided according to the use of lipid-lowering therapy: those with statin treatment (79 eyes of 73 patients) and those taking no statin medication (113 eyes of 98 patients). One-month best-corrected visual acuity (BCVA) gain and cumulative 12-month revitrectomy frequency were analyzed.


RESULTS
In multivariate linear regression, diabetic patients with statin treatment had a better 1-month BCVA improvement than did those without statin treatment (absolute difference 0.26, 95% confidence interval [CI] 0.02-0.50, p = 0.028). Subgroup analysis revealed that diabetic patients on statin had better postoperative BCVA improvement when preoperative status included partial or panretinal laser photocoagulation (p = 0.042 and p = 0.049) and anti-vascular endothelial growth factor therapy (p = 0.011). Moreover, diabetic patients with preoperative macular edema (p = 0.009), vitreous hemorrhage (p&lt;0.001), proliferative retinopathy (p&lt;0.001), or tractional retinal detachment (p = 0.010) had better BCVA recovery if receiving statin. In Cox proportional hazards regression model, revitrectomies in our 12-month follow-up were less frequent in diabetic patients on statin treatment (hazard ratio 0.28, 95% CI 0.08-0.93, p = 0.037).


CONCLUSIONS
These data provide novel insight into the potential clinical benefit for patients with sight-threatening diabetic retinopathy undergoing vitrectomy treated with statin.
Department of Ophthalmology, Kymenlaakso Central Hospital, Kotka - Finland.|Helsinki Retina Research Group, Faculty of Medicine, University of Helsinki, Helsinki - Finland.
Raimo
R
Tuuminen
Department of Anesthesiology and Intensive Care Medicine, Helsinki University Central Hospital, Helsinki - Finland.
Sari
S
Sahanne
Department of Public Health, Faculty of Medicine, University of Helsinki, Helsinki - Finland.
Jari
J
Haukka
Unit of Vitreoretinal Surgery, Department of Ophthalmology, Helsinki University Hospital, Helsinki - Finland.
Sirpa
S
Loukovaara
D000328:Adult; D000368:Aged; D003922:Diabetes Mellitus, Type 1 / Q000503:physiopathology / Q000628:therapy; D003924:Diabetes Mellitus, Type 2 / Q000503:physiopathology / Q000628:therapy; D003930:Diabetic Retinopathy / Q000188:drug therapy / Q000503:physiopathology / Q000601:surgery / Q000628:therapy*; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D008269:Macular Edema / Q000188:drug therapy / Q000503:physiopathology / Q000601:surgery / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014792:Visual Acuity / Q000502:physiology; D014821:Vitrectomy
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors