2017, Number 1
Complications on vitrectomy because of diabetic retinopathy and its relation to HbA1c levels
Márquez-Cardona ET, Arévalo-Simental DE, Cisneros-Gómez S, Becerra-Cota M, Soria-Orozco CL, Cortes-Quezada S, Roig ME
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Language: Spanish
References: 9
Page: 32-36
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ABSTRACT
Introduction. Diabetic retinopathy is the third cause of irreversible blindness in the world, but the first on working-age population (16 to 64) in developing countries (1) (2), it is important to highlight that the disease is the main microvascular complication presented on diabetic patients. The metabolic control is fundamental for the treatment of diabetic retinopathy and its complications (3). Today, even though it is general knowledge amongst the physician specialized on retina that post-surgical complications are more frequent on vitrectomy on patients who have a bad glycemic and metabolic control. However, this is not backed with studies, because of this we consider of importance and relevancy to make a systemized approach to this situation due to the great impact that it would have in social and working rehabilitation of patients who suffer Diabetes Mellitus and in, particularly, Diabetic Retinopathy. The objective of this work is to describe the incidence of complication on postsurgical vitrectomy patients and its relation with the percentage of Glycated hemoglobin (HbA1c)Material and Methods. Retrospective study that included patients who underwent Phacoemulsification and vitrectomy or vitrectomy simple for diabetic retinopathy on the Fray Antonio Alcalde Civil Hospital of Guadalajara Retina Service. We used a data collection instrument and posteriorly performed a statistically analysis of the results.
Results. We included 101. The range of age was 33 to 74, with a mean of 57.35 years old. 72% (73 patients) presented Hb1Ac higher that 7% setting them on the poor glycemic control, 28% (28) was placed in the good glycemic control with HbA1c under 7%. The poor control group registered 21 cases with complications (27%), the good control group presented 4 cases with complications (17%).
Conclusions. The patients in the poor glycemic control group presented a higher percentage of complications with 27% of the cases, in contrasts to the 17% from the good glycemic control group. We consider of importance that this analysis generates new study protocols with the necessary characteristics to establish better pre-surgical criteria. We believe it is necessary to make an analysis of the problems in a prospective and analytical manner with a sample that is enough to set valid and trustful pre-surgical criteria.
REFERENCES
DCCT ResearchGroup. The Diabetes Control and Complications Trial (DCCT). Design and methodologic considerations for the feasibility phase. The DCCT ResearchGroup. Diabetes 1986; 35: 530-45. 5.Diabetic Retinopathy Vitrectomy Study Research Group. Early vitrectomy for severe vitreous hemorrhage in diabetic retinopathy. Arch Ophthal 1985; 103:1644-52.