title: Long-Term Survival Rates of Patients Undergoing Vitrectomy for Proliferative Diabetic Retinopathy.
abstract: OBJECTIVE
  Reported 5-year survival rates in patients undergoing vitreous surgery for proliferative diabetic retinopathy (PDR) range from 68-95%. Studies relating survival rates to medical baseline characteristics predate the millennium. This study aimed to update data on life expectancy of patients undergoing vitrectomy for PDR and identify baseline factors which may influence survival.
  
  
  METHODS
  A retrospective cohort study of consecutive patients who underwent their first pars-plana vitrectomy for PDR between April 2004 and May 2005 was performed. Survival status on 1 May 2012 was the primary endpoint. The Kaplan-Meier life table method was used to determine survival rates. Univariate and multiple variable Cox proportional hazards regressions were used to identify risk factors for mortality.
  
  
  RESULTS
  A total of 148 patients were included in the study, with a mean age of 54 years (range 20-80 years) at time of surgery. The 3-, 5- and 7-year survival rates were 94%, 86% and 77%, respectively (95% confidence interval, CI, 88-97%, 79-91% and 68-84%, respectively). Renal failure was the most common cause of death. The presence of limb ulcers at baseline was the most important prognostic indicator for mortality, with a hazard ratio of 3.13 (95% CI 1.46-6.71, p = 0.003) and a survival rate at 5 years reduced to 79%.
  
  
  CONCLUSIONS
  The 5-year survival rate remains comparable to those reported 20 years ago despite a lowering in threshold for vitrectomy and increased health awareness. Limb ulcers are strongly associated with increasing mortality. Clinicians should remain mindful of the systemic associations of diabetes particularly in advanced retinal disease.
authors.affiliation: a Moorfields Eye Hospital , London , UK.
authors.forename: Philip J
authors.initials: PJ
authors.lastname: Banerjee
authors.affiliation: a Moorfields Eye Hospital , London , UK.|b Fundación Oftalmológica Los Andes , Santiago , Chile.
authors.forename: Rene
authors.initials: R
authors.lastname: Moya
authors.affiliation: a Moorfields Eye Hospital , London , UK.
authors.forename: Catey
authors.initials: C
authors.lastname: Bunce
authors.affiliation: a Moorfields Eye Hospital , London , UK.
authors.forename: David G
authors.initials: DG
authors.lastname: Charteris
authors.affiliation: a Moorfields Eye Hospital , London , UK.|c Tennent Institute of Ophthalmology , Glasgow , Scotland , UK.
authors.forename: David
authors.initials: D
authors.lastname: Yorston
authors.affiliation: a Moorfields Eye Hospital , London , UK.
authors.forename: Louisa
authors.initials: L
authors.lastname: Wickham
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003922:Diabetes Mellitus, Type 1 / Q000453:epidemiology; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology; D003930:Diabetic Retinopathy / Q000401:mortality* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008017:Life Expectancy; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D015996:Survival Rate; D014821:Vitrectomy / Q000401:mortality*; D055815:Young Adult
keywords: Diabetes; proliferative diabetic retinopathy; survival; vitrectomy; vitreous