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Surgical strategy and outcome in patients with bilateral proliferative diabetic retinopathy

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Abstract

Objectives

To investigate the current surgery strategies for bilateral proliferative diabetic retinopathy (PDR), as well as the surgical outcomes of patients with bilateral PDR who underwent pars plana vitrectomy (PPV).

Materials

Patients undergoing bilateral vitrectomy for PDR from January 2019 to December 2020 at The Eye Hospital of Wenzhou Medical University were enrolled. Clinical data were collected from the electronic medical records. Factors associated with the time interval between the surgeries on two eyes and postoperative visual outcomes were analyzed.

Results

In total, 152 patients with bilateral PDR who underwent bilateral PPV were included in this analysis. Mean age was 53.7 ± 11.4 years. Compared with second-surgery eyes, 60.5% of first-surgery eyes had worse preoperative best-corrected visual acuity (BCVA). The overall PPV time (median, quartile range) between first and second surgeries eye was 1.40 (0.70, 3.15) months. Multivariate analysis showed that the preoperative BCVA of the second-surgery eye had a significant effect on the inter-surgery time interval (P = 0.048). First-surgery eyes had greater vision improvement than second-surgery eyes (Difference of the logarithm of the minimum angle of resolution [LogMAR] BCVA: − 1.00 [− 1.48, − 0.12] versus 0.00 [− 1.30, 0.00], respectively, P < 0.001), especially when eyes with poorer BCVA underwent PPV first (− 1.15 [− 1.87, − 0.54] versus 0.00 [− 0.70, 0.00], respectively, P < 0.001).

Conclusions

Visual acuity is a significant factor that influences surgical strategies, including both surgery order and interval, for patients with bilateral PDR. The eyes operated upon first show more vision improvement due to prompt surgery.

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Data availability

The original contributions presented in the study are included in the article, further inquiries can be directed to the corresponding author.

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Funding

Zhejiang Provincial High Level Health Talents Training Project (No.CZ-RC2022010).

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Authors and Affiliations

  1. National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, No. 270 West College Road, Wenzhou, 325027, Zhejiang, China

    Jun Hong Jiang, Rong Han Wu, Ming Xue Ren, Ke Lin, Wei Lin, Xu Ting Hu, Feng Chen, Zhen Quan Zhao, Li Na Ge & Zhong Lin

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  1. Jun Hong Jiang
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  4. Ke Lin
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  7. Feng Chen
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Contributions

JJ, RW, and ZL: study conception and design. MR, KL, XH, FC, ZZ and LG: data collection, analysis and interpretation. JJ: drafting the manuscript. RW, and ZL: revising the manuscript. All authors contributed to the article and approved the submitted version.

Corresponding author

Correspondence to Zhong Lin.

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Conflict of interest

The authors declare that they have no conflicts of interest.

Ethical approval

Approval for the study was granted by the Ethics Committee of the Eye Hospital of Wenzhou Medical University, approval number [2020-079-K-71]. The study was conducted in accordance with the tenets of the Declaration of Helsinki. Written informed consent was obtained from all participants.

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Informed consent was obtained from all individuals included in the study.

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Jiang, J.H., Wu, R.H., Ren, M.X. et al. Surgical strategy and outcome in patients with bilateral proliferative diabetic retinopathy. Int Ophthalmol 43, 4921–4931 (2023). https://doi.org/10.1007/s10792-023-02895-9

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  • DOI: https://doi.org/10.1007/s10792-023-02895-9

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