增生性糖尿病视网膜病变玻璃体切割术后发生玻璃体积血的危险因素分析OA

Objective To investigate risk factors for postoperative vitreous hemorrhage(PVH)in patients with prolifera-tive diabetic retinopathy(PDR)following vitrectomy.Methods A retrospective nested case-control study based on a cohort was conducted.From January 2021 and January 2024,patients who underwent primary vitrectomy for PDR were enrolled.Those who de-veloped PVH after surgery were assigned to the case group,and patients without PVH were matched to the control group at a 1∶3 ratio.Data of two groups were compared to identify the potential influencing factors for PVH after vitrectomy.Results Total 809 PDR patients were included,among whom 62 cases(7.7％)developed postoperative PVH and 747 cases(92.3％)did not.Uni-variate analysis revealed that there were statistically significant differences in terms of diabetes duration,dialysis status,anti-VEGF therapy within one week before surgery,anti-VEGF therapy at the end of surgery,intraocular pressure(IOP)on the first postopera-tive day,and incision suture at the end of surgery(P＜0.05).No significant differences were observed in other baseline data(P＞0.05).Multivariate Logistic regression analysis showed that longer diabetes duration(OR=1.072,95％CI 1.018～1.128),dialy-sis treatment(OR=2.758,95％CI 1.148～6.629),anti-VEGF therapy within one week preoperatively(OR=0.429,95％CI 0.198～0.928),and low IOP on the first postoperative day(OR=0.928,95％CI 0.865～0.996)were significantly associated with PVH(P＜0.05).Conclusion Longer duration of diabetes mellitus,low intraocular pressure on the first postoperative day,and dialysis treatment are risk factors for PVH after vitrectomy in PDR patients,while anti-VEGF therapy within one week before surgery serves as a protective factor against PVH.