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Perioperative systemic blood pressure parameters and clinical outcomes following 27g vitrectomy for diabetic tractional detachment repair.
Ambati, Naveen R; Chernyavskiy, Pavel; Cai, Xiaoyu; Duong, Ryan T; Shildkrot, Eugene Y.
Afiliación
  • Ambati NR; Department of Ophthalmology, University of Virginia School of Medicine, Charlottesville, Virginia, USA.
  • Chernyavskiy P; Department of Public Health Sciences, University of Virginia School of Medicine, Charlottesville, VA, USA.
  • Cai X; Department of Ophthalmology, University of Virginia School of Medicine, Charlottesville, Virginia, USA.
  • Duong RT; Department of Ophthalmology, University of Virginia School of Medicine, Charlottesville, Virginia, USA.
  • Shildkrot EY; Department of Ophthalmology, University of Virginia School of Medicine, Charlottesville, Virginia, USA shildkrot@gmail.com.
BMJ Open Ophthalmol ; 8(1)2023 01.
Article en En | MEDLINE | ID: mdl-37278428
BACKGROUND: Extremes in perioperative blood pressures are known risk factors for adverse outcomes after surgical interventions. There is scarce literature studying these parameters as predictors of outcomes after ocular surgery. METHODS: This was a retrospective single-centre interventional cohort analysis to evaluate the relationship between perioperative (preoperative and intraoperative) blood pressure value and variability and postoperative visual and anatomic outcomes. Included were patients who underwent primary 27-gauge (27g) vitrectomy for repair of diabetic tractional retinal detachment (DM-TRD) with at least 6 months of follow-up. Univariate analyses were conducted via independent two-sided t-tests and Pearson's χ2 tests. Multivariate analyses were conducted via generalised estimating equations. RESULTS: 71 eyes of 57 patients were included in the study. Higher preprocedure mean arterial pressure (MAP) was associated with fewer Snellen lines of improvement at postoperative month 6 (POM6) (p<0.01). Higher mean intraoperative systolic blood pressure (SBP), diastolic blood pressure and MAP were associated with visual acuity 20/200 or worse at POM6 (p<0.05). Patients with sustained intraoperative hypertension had 1.77 times the risk of visual acuity 20/200 or worse at POM6 compared with those without sustained intraoperative hypertension (p=0.006). Higher SBP variability was associated with worse visual outcomes at POM6 (p<0.05). Blood pressure was not associated with macular detachment at POM6 (p>0.10). CONCLUSIONS: Higher average perioperative blood pressure and blood pressure variability are associated with worse visual outcomes in patients undergoing 27g vitrectomy for DM-TRD repair. Patients with sustained intraoperative hypertension were approximately twice as likely to have visual acuity 20/200 or worse at POM6 compared to those without sustained intraoperative hypertension.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Diabetes Mellitus / Retinopatía Diabética / Hipertensión Tipo de estudio: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: BMJ Open Ophthalmol Año: 2023 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Diabetes Mellitus / Retinopatía Diabética / Hipertensión Tipo de estudio: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: BMJ Open Ophthalmol Año: 2023 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido