A Review of the Indications, Outcomes, and Complications of Pars Plana Vitrectomy for Vitreous Hemorrhage at an Urban Eye Hospital in Nairobi, Kenya

Abstract

Objective: We aimed to determine the indications of PPV in patients with VH, the complications associated with the surgery, and if the duration of VH affects visual outcomes. Study Design and Setting: The study was a retrospective case series in a tertiary eye center (City Eye Hospital) in Kenya for the year 2019-2020. Materials and Methods: The census method was used in sampling, and all records of patients that had PPV for VH in 2019-2020 were enlisted. Visual outcomes for these patients were evaluated along with accompanying complications. Pearson coefficient was used to determine correlation between visual outcome and patient presenting features, and any associations with a p-value of <0.05 were included in a multivariable analysis according to strength of association. Results: 65 eyes of 63 patients were enlisted in the study with a female: male ratio of 1:1.6 and a mean age of 54.9 (SD 16.2) years. 78.5% and 52.4% of patients had diabetes and hypertension respectively. The commonest cause of VH in operated patients was PDR (66.9%), with other causes being CRVO (6.1%), BRVO (4.6%), trauma (3.1%), Eale’s and AMD (1.5% each). We noted significant BCVA improvement from baseline, and this change was not affected by gender (P = 0.292), timing of PPV (P = 0.665), density of VH (P = 0.617), and preoperative Anti-VEGF (P = 0.461). The complications encountered were rebleeding (10.8%), cataract in (6.2%), optic atrophy (6.2%), RD in (6.2%) eyes, and high intraocular pressure (6.2%). 66.2% had no postoperative complication. Complications negatively affected vision (p=0.002). Conclusions: PDR is the commonest cause of VH in patients that needed PPV. There was significant visual improvement post PPV for VH. The commonest complication was rebleeding.