[Effect of rubeosis iridis and active neovascularization of the fundus on vitreous surgery in diabetic retinopathy].
To determine the influence of preoperative rubeosis iridis and active neovascularization at the fundus on surgical results, the authors analyzed a consecutive series of 85 eyes that underwent vitrectomy for diabetic tractional detachment of the macula. Minimum follow-up was 12 months. Rubeosis was present in 51%, active neovascularization at the fundus in 82%. Surgery was performed under Spitznas wide-angle observation using a stereoscopic diagonal inverter either with the panfundoscope or binocular ophthalmoscopy through the operating microscope. In the 93% of the eyes that were phakic no lensectomy was performed. Anatomical success was achieved in 79%, ambulatory vision in 74%. Anatomical success was reduced to 58% in cases with preoperative rubeosis and to 70% in cases with active neovascularization at the fundus. Including four cases of re-vitrectomy, silicone oil was used for internal tamponade in 9%, SF 6/air 50:50 in 38% and air in 28%. In 25% no internal tamponade was applied. Postoperative complications included vitreous bleeding (21%), increased rubeosis (20%), neovascular glaucoma (2%), redetachment (6%), rubeosis/hypotony/cataract (13%) and phthisis (3.5%). In 21% of the eyes the final result of surgery was failure, due to redetachment (3.5%), neovascular glaucoma (1%), rubeosis/hypotony/cataract (13%) and phthisis (3.5%).
Oldendoerp
J
J
Universitäts-Augenklinik Bonn.
Spitznas
M
M
D000328:Adult; D000368:Aged; D003930:Diabetic Retinopathy / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007431:Intraoperative Complications / Q000503:physiopathology; D007498:Iris / Q000098:blood supply*; D008875:Middle Aged; D009389:Neovascularization, Pathologic / Q000503:physiopathology*; D011183:Postoperative Complications / Q000503:physiopathology; D011379:Prognosis; D012008:Recurrence; D012163:Retinal Detachment / Q000503:physiopathology / Q000601:surgery; D012171:Retinal Vessels / Q000503:physiopathology*; D014792:Visual Acuity; D014821:Vitrectomy
Der Einfluss von Rubeosis iridis und aktiven Neovaskularisationen am Fundus auf die Ergebnisse der Glaskörperchirurgie bei der proliferativen diabetischen Retinopathie.