Tasa de resangrado vítreo posterior a vitrectomía o facovitrectomía en pacientes con retinopatía diabética proliferativa: estudio retrospectivo / Vitreous rebleeding rate after vitrectomy or phacovitrectomy in patients with proliferative diabetic retinopathy: A retrospective study

Antecedentes: La complicación más común tras la vitrectomía en pacientes es el resangrado en cavidad vítrea. Es importante detectar los distintos factores que pueden incrementar la tasa de resangrado vítreo en estos pacientes. Objetivo: Realizar una revisión retrospectiva de la tasa de resangrado de cavidad vítrea posterior a vitrectomía o facovitrectomía. Método: Estudio retrospectivo, descriptivo y comparativo de pacientes con diagnóstico de retinopatía diabética proliferativa con procedimiento de facovitrectomía o vitrectomía. Se obtuvieron datos de antecedentes personales patológicos, tipo de intervención quirúrgica y grado del cirujano que realizó el procedimiento. Resultados: Se revisaron 1.227 expedientes de pacientes diabéticos sometidos a vitrectomía o facovitrectomía. El 65% presentaron hipertensión arterial sistémica. La tasa de filtración glomerular promedio fue del 63,50 (±32,36) ml/min/1,73m2 y la de hemoglobina glucosilada (HbA1c) del 8% (4,6 al 15%). En la comparación de variables se obtuvo una diferencia significativa de la tasa de resangrado vítreo comparando la facovitrectomía con la vitrectomía (p=0,003), y al relacionar la vitrectomía con el resangrado, se obtuvo una razón de momios de 1,44. Conclusión: Los resultados obtenidos muestran una menor tasa de resangrado en los pacientes con retinopatía diabética proliferativa sometidos a facovitrectomía.(AU)

Background: The most common complication after vitrectomy is the rebleeding in vitreous cavity. It is important to detect the different factors that can increase the vitreous rebleeding rate in these patients. Objective: To carry out a retrospective review of the rate of vitreous rebleeding after vitrectomy or phacovitrectomy. Method: Retrospective, descriptive and comparative study of patients with a diagnosis of proliferative diabetic retinopathy with phacovitrectomy or vitrectomy procedure. Personal background data, type of surgical intervention and grade of the surgeon who carried out the procedure were obtained. Results: One thousand two hundred twenty-seven files of diabetic patients with vitrectomy or phacovitrectomy were reviewed. Sixty-five percent presented systemic arterial hypertension. The average glomerular filtration rate was 63.50 (±32.36)ml/min/1.73m2 and glycosylated hemoglobin (HBA1C) of 8% (4.6-15%). In the comparison of variables, a significant difference in the rate of vitreous rebleeding was obtained comparing phacovitrectomy with vitrectomy (P=.003), in the relationship between vitrectomy with vitreous rebleeding, an odds ratio of 1.44 was obtained. Conclusion: The results obtained show a lower rate of rebleeding in patients undergoing phacovitrectomy in patients with proliferative diabetic retinopathy.(AU)

Vitreous rebleeding rate after vitrectomy or phacovitrectomy in patients with proliferative diabetic retinopathy: A retrospective study.

BACKGROUND: The most common complication after vitrectomy is the rebleeding in vitreous cavity. It is important to detect the different factors that can increase the vitreous rebleeding rate in these patients. OBJECTIVE: To carry out a retrospective review of the rate of vitreous rebleeding after vitrectomy or phacovitrectomy. METHOD: Retrospective, descriptive and comparative study of patients with a diagnosis of proliferative diabetic retinopathy with phacovitrectomy or vitrectomy procedure. Personal background data, type of surgical intervention and grade of the surgeon who carried out the procedure were obtained. RESULTS: 1227 files of diabetic patients with vitrectomy or phacovitrectomy were reviewed. 65% presented systemic arterial hypertension. The average glomerular filtration rate was 63.50 (±32.36) ml/min/1.73 m2 and glycosylated hemoglobin (HBA1C) of 8% (4.6 to 15%). In the comparison of variables, a significant difference in the rate of vitreous rebleeding was obtained comparing phacovitrectomy with vitrectomy. (p = 0.003), in the relationship between vitrectomy with vitreous rebleeding, an odds ratio of 1.44 was obtained. CONCLUSION: The results obtained show a lower rate of rebleeding in patients undergoing phacovitrectomy in patients with proliferative diabetic retinopathy.

Dynamics of glycerine and water transport across human skin from binary mixtures.

OBJECTIVE: Skin transport properties of glycerine and water from binary mixtures contacting human skin were determined to better understand the mechanism of skin moisturization by aqueous glycerine formulations. METHODS: Steady-state permeation for 3 H2 O and 14 C-glycerine across split-thickness human skin in vitro and desorption dynamics of the same permeants in isolated human stratum corneum (HSC) were experimentally determined under near equilibrium conditions. These data were compared to a priori values developed in the context of a thermodynamic model for binary mixtures of glycerine and water and a previously determined water sorption isotherm for HSC. This allowed the estimation of diffusion and partition coefficients for each permeant in the HSC, as well as HSC thickness, as a function of composition of the contacting solution. These data may be used to estimate water retention and associated HSC swelling related to the absorption and slow release of glycerine from the skin. RESULTS: It took 6+ days for glycerine to completely desorb from HSC immersed in glycerine/water binary solutions. Desorption of both 3 H2 O and 14 C-glycerine from HSC was slower in pure water than from binary mixtures, a result that is largely explained by the greater swelling of HSC in water. Parametric relationships were developed for water and glycerine intradiffusivities in HSC as functions of HSC water content, and a mutual diffusion coefficient was estimated by analogy with glycerine/water binary solutions. The intradiffusivity of 14 C-glycerine in HSC as inferred from sorption/desorption experiments was shown to be approximately 10-fold less than that inferred from permeation experiments, whereas the corresponding values for 3 H2 O were comparable. CONCLUSION: These studies confirm that glycerine enters HSC in substantial quantities and has a long residence time therein. The coupling between bulk water and glycerine transport projected from binary solution data suggests the net effect of glycerine is to slow water loss from the skin. The data support the concept of glycerine as a humectant with an excellent balance of skin penetration and retention characteristics; however, they do not rule out the possibility of an additional biological effect on skin barrier homoeostasis.