Vitrectomy for diabetic retinopathy in patients undergoing hemodialysis for associated end-stage renal failure
Hayashi, H.; Kurata, Y.; Imanaga, Y.; Goya, K.; Oshima, K.
Retina 18(2): 156-159
1998
ISSN/ISBN: 0275-004X PMID: 9564697 Document Number: 488118
Purpose: Candidates for diabetic vitrectomy often have concurrent renal dysfunction and have undergone hemodialysis. The influence of hemodialysis on the surgical outcome of vitrectomy was investigated. Methods: Vitrectomy was performed on 76 eyes with proliferative diabetic retinopathy in 66 patients with end-stage renal failure who had undergone hemodialysis. Follow-up was longer than 1 year. Results: No uncontrollable hemorrhage occurred either during or immediately after the surgery. Final visual acuity after surgery was the same as preoperative visual acuity in 31.5% of the eyes; improvement was seen in 60.5% of the eyes. A final visual acuity of 0.2 or better was observed in 57.6% of the eyes. Major postoperative complications included recurrent vitreous hemorrhage, rhegmatogenous retinal detachment, fibrin clot formation, neovascular glaucoma, flat anterior chamber, and a transient rise in intraocular pressure. Conclusion: Renal failure and hemodialysis do not appear to have a deteriorative influence on the outcome of vitrectomy for proliferative diabetic retinopathy. A flat anterior chamber seems to be a rare and perhaps unique postoperative complication of gas-filled eyes in patients who have undergone hemodialysis.