Comparison of Surgical Result of Vitrectomy vs Combined Phacoemulsification and Vitrectomy in Patients with Diabetic Vitreous Hemorrhage

ABSTRACT

In eyes with diabetic vitreous hemorrhage, relatively significant improvement of visual acuity has been achieved by vitrectomy.However, visual loss occurs not infrequently due to iris neovascularization or ma, one of the serious complications of vitrectomy for proliferative diabetic retinopathy.We have retrospectively studied the visual acuity and complications in 43 patients (50 eyes)who underwent only vitrectomy (group A)and in 63 patients (64 eyes)who underwent combined phacoemulsification, vitrectomy and posterior chamber intraocular lens (PCL)implantation (group B), from January of 1997 to June of 1999.The age distribution was 30 to 65 years (mean 47 years)in group A and 32 to 78 years (mean 57 years)in group B.The duration of follow up was more than 6 months.The final visual outcome showed the improvement in 84.0%, no change in 6.0%and the worsening in 10.0%in group A and the improvement in 93.7%, no change in 4.7% and the worsening in 1.6%in group B.The iris neovascularization and neovascular glaucoma occurred 10.0%in group A and 4.7%in group B but this difference was not significant statistically (p=0.271).We performed cataract operations in 30%of group A eyes postoperatively.The results of this study suggest that combined phacoemulsification, vitrectomy and PCL implantation are relatively safe and effective procedure for patients with diabetic vitreous hemorrhage.