FREQUENCY AND RISK FACTORS OF PERSISTENT CORNEAL EPITHELIAL DEFECT IN DIABETIC PATIENTS UNDERGOING PARS PLANA VITRECTOMY

Abstract

Background: Persistent corneal epithelial defect (PCED) is a significant postoperative complication that can occur after pars plana vitrectomy (PPV), particularly in diabetic patients. It may delay corneal healing, impair visual recovery, and increase the risk of ocular morbidity.

Objective: To estimate the frequency and risk factors of persistent corneal epithelial defects (PCED) among diabetic patients undergoing pars plana vitrectomy (PPV).

Material and Methods: This Retrospective study was carried out in the outpatient department of ophthalmology at Hayatabad HMC Peshawar Medical Complex from January 2017 to December 2018. The sample of 437 (511 eyes) that underwent PPV from 2017 to 2018 was studied. If the patient had epithelial defects in cornea, edematous cornea or superficial punctuate keratopathy within first week after PPV, was labeled as complications of the cornea. However, if the complications of the cornea persist for more than 14 days after conservative treatment, the patient was labeled as a persistent corneal epithelial defect (PCED). The diabetic patients were grouped in two i.e. PCED and non-PCED. The sociodemographic and clinical/ surgical data were analyzed and outcomes were assessed. For statistical analysis, SPSS version 24 was used. P value was calculated and considered significant if it was less than 0.05.

Results: After PPV corneal complications were developed among 114 eyes of 437 subjects (22%), while PCED was developed among 38 eyes out of 114 eyes (33%).The chi square P value of PCED, SPK and Corneal Edema were (0.032), (0.003) and (0.936) respectively. Among those eyes that developed complications, 22 eyes progressed to PCED. Poor visual acuity was observed among eyes with PCED with (P = 0.035). After most suitable statistic tests applied to the data, the results showed that among the risk factors of PCED after PPV, diabetes mellitus has significant association.

Conclusion: There was an association of diabetes and PCED with p value of (p=0.03). Diabetes mellitus, perfluoropropane intravitreal tamponade, and assistance of first-year resident were among the risk factors. Poor visual acuity was observed among these patients. Initially aggressive treatment is required for patients with corneal epithelial defects after surgery to avoid unfavorable results.