Abstract
A consecutive series of 100 vitrectomies for tractional retinal detachment involving the macula in proliferative diabetic retinopathy was analyzed to determine the influence of preoperative iris rubeosis (NVI) and active neovascularization at the fundus (NVF) on surgical results. The minimum follow-up was 12 months. Preoperatively, iris rubeosis was present in 52% and active neovascularization at the fundus in 85%. Surgery was performed under Spitznas wide-angle observation, using a stereoscopic diagonal inverter, either with the panfundoscope or binocular ophthalmoscopy through the operating microscope. Most of the eyes were phakic (94%). No lensectomy was performed. Anatomical success was achieved in 81%, ambulatory vision in 77%. Anatomical success was reduced to 63% in cases with preoperative NVI and to 78% in cases with preoperative NVF. Including 5 cases of re-vitrectomy, silicone oil was used for internal tamponade in 9%, SF 6/air 50:50 in 39% and air in 26%. In 26%, no internal tamponade was applied. Postoperative complications consisted of vitreous hemorrhage (25%), increased rubeosis (22%), neovascular glaucoma (2%), and redetachment (7%). The final causes of failure in 19% of eyes were: neovascular glaucoma (1%), rubeosis/hypotony/cataract (14%), and phthisis bulbi (4%).
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Aaberg TM (1981) Pars plana vitrectomy for diabetic traction retinal detachment. Ophthalmology 88:639–642
Barrie T, Feretis E, Leaver P, McLeod D (1982) Closed microsurgery for diabetic traction macular detachment. Br J Ophthalmol 66:754–758
Blankenship G (1980) Preoperative iris rubeosis and diabetic vitrectomy results. Ophthalmology 87:176–182
Blankenship G (1982) Preoperative prognostic factors in diabetic pars plana vitrectomy. Ophthalmology 89:1246–1249
Blankenship G, Cortez R, Machemer R (1979) The lens and pars plana vitrectomy for diabetic retinopathy complications. Arch Ophthalmol 97:1263–1267
Blankenship GW (1980) The lens influence on diabetic vitrectomy results. Arch Ophthalmol 98:2196–2198
Blankenship GW, Machemer R (1985) Long-term diabetic vitrectomy results. Ophthalmology 92:503–506
Faulborn J (1984) Indikation zur Silikonölimplantation bei fortgeschrittener proliferativer diabetischer Retinopathie. Klin Monatsbl Augenheilkd 185:362–363
Gnad H, Skorpik C, Paroussis P, Menapace R, Radda TM, Prskavec FH, Grasl M (1986) Temporäre Silikonöl-Implantation bei proliferativer diabetischer Retinopathie. Klin Monatsbl Augenheilkd 189:388–390
Goodart R, Blankenship G (1980) Panretinal photocoagulation influence on vitrectomy results for complications of diabetic retinopathy. Ophthalmology 87:183–188
Hutton WL, Bernstein I, Fuller D (1980) Diabetic traction retinal detachment. Ophthalmology 87:1071–1077
Lambrou FH, Burke JM, Aaberg TM (1987) Effect of silicone oil on experimental traction retinal detachment. Arch Ophthalmol 105:1269–1272
Lean JS, Leaver PK, Cooling RJ, McLeod D (1982) Management of complex retinal detachments by vitrectomy and fluid/silicone exchange. Trans Ophthalmol Soc UK 102:203–205
Machemer R, Blankenship G (1981) Vitrectomy for proliferative diabetic retinopathy associated with vitreous hemorrhage. Ophthalmology 88:643–646
Michels RG (1978) Vitrectomy for complications of diabetic retinopathy. Arch Ophthalmol 96:237–246
Michels RG, Rice TA, Rice EF (1983) Vitrectomy for diabetic vitreous hemorrhage. Am J Ophthalmol 95:12–21
Rice TA, Michels RG, Maguire MG, Rice EF (1983) The effect of lensectomy on the incidence of iris neovascularization and neovascular glaucoma after vitrectomy for diabetic retinopathy. Am J Ophthalmol 95:1–11
Rice TA, Michels RG, Rice EF (1983) Vitrectomy for diabetic traction retinal detachment involving the macula. Am J Ophthalmol 95:22–33
Rinkoff JS, de Juan E, McCuen BW II (1986) Silicone oil for retinal detachment with advanced proliferative vitreoretinopathy following failed vitrectomy for proliferative diabetic retinopathy. Am J Ophthalmol 101:181–186
Spitznas M (1987) A binocular indirect ophthalmomicroscope (BIOM) for non-contact wide-angle vitreous surgery. Graefe's Arch Clin Exp Ophthalmol 225:13–15
Spitznas M, Reiner J (1987) A stereoscopic diagonal inverter (SDI) for wide-angle vitreous surgery. Graefe's Arch Clin Exp Ophthalmol 225:9–12
Thompson JT, Auer CL, Bustros S de, Michels RG, Rice TA, Glaser BM (1986) Prognostic indicators of success and failure in vitrectomy for diabetic retinopathy. Ophthalmology 93:290–295
Thompson JT, Bustros S de, Michels RG, Rice TA, Glaser BM (1986) Results of vitrectomy for proliferative diabetic retinopathy. Ophthalmology 93: 1571–1574
Tolentino FI, Freeman HM, Tolentino FL (1980) Closed vitrectomy in the management of diabetic traction retinal detachment. Ophthalmology 87:1078–1089
Yeo JH, Glaser BM, Michels RG (1987) Silicone oil in the treatment of complicated retinal detachments. Ophthalmology 94:1109–1113
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Oldendoerp, J., Spitznas, M. Factors influencing the results of vitreous surgery in diabetic retinopathy. Graefe's Arch Clin Exp Ophthalmol 227, 1–8 (1989). https://doi.org/10.1007/BF02169815
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF02169815