Visual and Anatomical Outcomes of Early versus Delayed Vitrectomy in Diabetic Vitreous Hemorrhage

Background: Diabetic vitreous hemorrhage is a vision-threatening complication of proliferative diabetic retinopathy. Pars plana vitrectomy is commonly performed, but the ideal timing ofsurgery remains clinically important. Objective: To compare the visual and anatomical outcomes of early versus delayed vitrectomy in patients with diabetic vitreous hemorrhage. Methods: This cross-sectional analytical study was conducted at Lady Reading Hospital (MTI) Peshawar from April 2025 to April 2026 including 150 patients with diabetic vitreous hemorrhage. Patients were divided into early vitrectomy (n=75) and delayed vitrectomy (n=75) groups. Results: The mean age was 56.8 ± 8.7 years in the early group and 58.1 ± 9.1 years in the delayed group. Final BCVA was significantly better in the early vitrectomy group (0.71 ± 0.33 vs. 0.96 ± 0.42 logMAR; p<0.001). Improvement of ≥2 lines was achieved in 61 (81.3%) early cases compared with 48 (64.0%) delayed cases (p=0.02). Complete hemorrhage clearance (92.0% vs. 77.3%; p=0.01) and retinal attachment (96.0% vs. 86.7%; p=0.04) were also higher in the early group. Early vitrectomy independently predicted favorable visual outcome (aOR 3.18; p=0.002). Conclusion: Early vitrectomy provides better visual recovery and anatomical success than delayed vitrectomy in diabetic vitreous hemorrhage.

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