DefinePK

Research Objective

To investigate the surgical outcomes of 23-gauge vitrectomy with prior intravitreal bevacizumab for non-clearing diabetic vitreous hemorrhage.

Methodology

Prospective interventional case series conducted at the Ophthalmology Department, Allied Hospital, Faisalabad from January 1, 2022, to December 31, 2022. 50 patients with non-clearing vitreous hemorrhage (VH) were included. Patients underwent 3-port pars plana vitrectomy with 23G instrumentation. Data was analyzed using SPSS v. 25.0.

Methodology Flowchart

                        graph TD
    A["Patient Recruitment 50 patients with NCVH"] --> B["Pre-operative Assessment"];
    B --> C["Intravitreal Bevacizumab Injection"];
    C --> D["3-Port Pars Plana Vitrectomy with 23G Instrumentation"];
    D --> E["Post-operative Follow-up: 1 week, 1 month, 3 months"];
    E --> F["Data Collection"];
    F --> G["Data Analysis using SPSS v. 25.0"];
    G --> H["Conclusion"];                    

Discussion

Vitreous hemorrhage is a prevalent complication of uncontrolled diabetes. While observation is the initial management, non-clearing VH often necessitates vitrectomy. The study suggests that 23-gauge vitrectomy is a safe and feasible option, with improved visual acuity and manageable complications. The use of anti-VEGF drugs prior to surgery may reduce complications.

Key Findings

- 70% of patients were female.
- Mean age was 55.5 years.
- 8% of patients were type I diabetics.
- Pre-operative best corrected visual acuity (BCVA) improved from a median of 3/60 to a median of 6/36 post-operatively.
- Complete resolution of VH occurred in 84% of patients.
- Recurrent VH occurred in 12% of patients.
- The most common post-operative complication was raised intraocular pressure (38%).

Conclusion

23-gauge pars plana vitrectomy is a safe and effective option for patients with non-resolving diabetic vitreous hemorrhage. While visual acuity improves post-surgery, the outcome is dependent on the retinal status. Post-operative complications are minimal and generally manageable.

Fact Check

- The study included 50 patients. (Confirmed in "Patients and Methods" and "Results")
- Complete resolution of Vitreous Hemorrhage (VH) occurred in 84% of patients. (Confirmed in "Results")
- Raised intraocular pressure was the most common post-operative complication, affecting 38% of patients. (Confirmed in "Results")

Mind Map