Reoperation following diabetic vitrectomy.
A review of 484 consecutive eyes that were undergoing an initial pars plana vitrectomy for the sequelae of proliferative diabetic retinopathy disclosed that 41 eyes (8.5%) required one or more additional vitrectomy operations. The primary causes for reoperation included rhegmatogenous retinal detachment in 18 (44%) of the 41 eyes, recurrent vitreous hemorrhage in 21 eyes (51%), and glaucoma in two eyes (5%). The visual prognosis was worse in the group with rhegmatogenous retinal detachment, with 10 (56%) of 18 eyes progressing to no light perception (P = .003). Severe preretinal and subretinal fibrous proliferation, as demonstrated histopathologically, accounted in large part for the poor result. The preretinal membrane formation appeared to occur secondary to a combination of diabetic extraretinal vascular growth and proliferative vitreoretinopathy. Among the total group of 41 eyes that required subsequent surgery, the retina eventually remained detached in 18 eyes (44%), and phthisis bulbi occurred in 13 eyes (32%). Rubeosis iridis developed in 17 (94%) of 18 eyes in which the retina remained detached.
Brown
G C
GC
Retina Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pa.
Tasman
W S
WS
Benson
W E
WE
McNamara
J A
JA
Eagle
R C
RC
D000328:Adult; D003930:Diabetic Retinopathy / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D005128:Eye Diseases / Q000473:pathology; D015353:Eye Enucleation; D005260:Female; D005901:Glaucoma / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012086:Reoperation; D012163:Retinal Detachment / Q000473:pathology / Q000601:surgery; D012164:Retinal Diseases / Q000473:pathology; D014792:Visual Acuity; D014821:Vitrectomy; D014822:Vitreous Body / Q000473:pathology; D014823:Vitreous Hemorrhage / Q000601:surgery