Long-term outcomes of vitrectomy for proliferative diabetic retinopathy: a real world study in China.

Purpose: To investigate long-term outcomes and their predictive factors in Chinese patients with proliferative diabetic retinopathy (PDR) after vitrectomy.

Study design: Retrospective and observational.

Methods: PDR patients who underwent vitrectomy in a tertiary eye hospital from 2010 to 2020 were enrolled. The cumulative incidences of re-vitrectomy in the primary eye, vitrectomy in the contralateral eye, low vision (< 0.3 Snellen), and postoperative complications were calculated.

Results: A total of 1094 patients were included in the analysis. The 1-, 3-, and 5-year cumulative incidences for low vision in both eyes were 18.9%, 34.7%, and 44.4%, respectively. The 1-, 5-, and 10-year cumulative incidences for re-vitrectomy in the primary eye were 7.4%, 9.9%, and 9.9%, respectively, and for vitrectomy in the contralateral eye were 31.0%, 62.7%, and 79.5%, respectively. Vitrectomy in the contralateral eye was associated with younger age (hazard ratio [HR] = 0.99, 95% confidence interval [CI] 0.98-0.99), higher glycated hemoglobin (HR = 1.17, 95% CI 1.08-1.27), no preoperative photocoagulation (HR = 0.55, 95% CI 0.39-0.78), severer diabetic retinopathy level (HR = 2.28, 95% CI 1.56-3.33), and poorer preoperative vision (HR = 1.35, 95% CI 1.14-1.61). The cumulative postoperative incidences of the primary eye at 1, 5, and 10 years were 5.7%, 9.9%, and 9.9% for vitreous hemorrhage, 4.2%, 5.1%, and 5.1% for retinal detachment, and 2.8%, 6.2%, and 8.1% for neovascular glaucoma, respectively.

Conclusion: This study reported a comprehensive post-vitrectomy incidence and predictive factors in Chinese PDR patients in a long-term follow up. This would aid in the clinical understanding of this lifelong disease.