The impact of renal function on pars plana vitrectomy for proliferative diabetic retinopathy and analysis of prognosis.

Abstract

To observe and analyze the impact of renal function on pars plana vitrectomy (PPV) for proliferative diabetic retinopathy (PDR). This retrospective study included 110 patients (110 eyes) who were divided into an impaired renal function (IRF) group (52 eyes) and a normal renal function (NRF) group (58 eyes) based on chronic kidney disease (CKD) staging. Patients were followed up and assessed preoperatively and throughout one year postoperatively. Independent risk factors affecting visual acuity recovery after PPV were also identified. Compared with the NRF group, the IRF group had significantly longer diabetes duration, higher serum creatinine and blood urea nitrogen, and lower hemoglobin and serum albumin (all P < 0.05). Preoperative laser treatment was more frequent in the NRF group, while intraoperative silicone oil tamponade was more common in the IRF group (both P < 0.05). Although the NRF group showed better best-corrected visual acuity (BCVA) at several postoperative time points (P < 0.05), the final visual improvement rate at 12 months did not differ significantly between groups (P = 0.156). No significant between-group differences were observed in postoperative complications. Multivariable analysis identified longer diabetes duration and lower serum albumin as independent risk factors for worse visual prognosis, whereas renal function itself was not an independent predictor. Worse baseline BCVA, shorter diabetes duration, and higher serum albumin independently predicted postoperative visual improvement, whereas renal function itself did not. The poorer visual outcomes associated with renal impairment were likely attributable to greater ocular and systemic disease burden.