The Clinical Results of Vitrectomy in Proliferative Diabetic Retinopathy with Diabetic Nephropathy

ABSTRACT

Many patients undergoing vitrectomy due to proliferative diabetic retinopathy also have diabetic ephropathy.Hence, to figure out the surgi-cal results of vitrectomy and the survival rate after vitrectomy in diabetic patients having diabetic nephropathy, we reviewed medical records of 70 patients[83 eyes]who had been followed for 3 months or longer after vitrectomy. Among them, 28 patients[33 eyes]were complicated by diabetic nephropathy.Visual acuity improved in 21 out of 33 eyes [63.6%]among the patients with nephropathy while vision improved in 29 out of 50 eyes[58.0%] among those without nephropathy.The two groups showed significant improvement of visual acuity postoperatively and the difference in visual acuity improvement between two groups was not statistically significant. The factors which affected postoperative visual acuity improvements in patients with diabetic nephropathy were preoperative panretinal photocoagulation[p=0.013]and intraoperative intraocular silicone oil injection[p=0.021]. Rate of occurrence of complications after vitrectomy and the types of the complications were similar in the two groups. During the 4-year follow up, 4 of 11 patients who had been on peritoneal dialysis or emodialysis died. These results showed that the result of vitrectomy for proliferative diabetic retinopathy in patients with iabetic nephropathy was not poor and suggested that diabetic nephropathy might not be a contraindication of vitrectomy for proliferative diabetic retinopathy.