Difficult Proliferative Diabetic Retinopathy

  • Ulrich Spandau
  • Heinrich Heimann


The surgery of a difficult proliferative diabetic retinopathy belongs to the most difficult vitreoretinal surgery possible. The timing is again of utmost importance. We propose a stepwise surgery in order to minimize vascular activity before vitrectomy. The surgery is shown step-by-step with many videos, drawings, and pictures.


Diabetic retinopathy Difficult proliferative diabetic retinopathy Proliferative diabetic retinopathy Vitrectomy 

Supplementary material

Video 15.1

Diabetic retinopathy for dummies (WMV 7019 kb)

Video 15.2

Advanced PDR (WMV 182553 kb)

Video 15.3

Advanced PDR with 27G_short (WMV 25528 kb)

Video 15.4

PDR_27G with EVA (WMV 114906 kb)

Video 15.5

Tractional retinal detachment in an African patient (WMV 38227 kb)

Video 15.6

Difficult diabetic retinopathy (PDVR) (WMV 897275 kb)


  1. 1.
    Arevalo JF, Maia M, Flynn HW, et al. Tractional retinal detachment following intravitreal bevacizumab (Avastin) in patients with severe proliferative diabetic retinopathy. Br J Ophthalmol. 2008;92:213–6.Google Scholar
  2. 2.
    da R Lucena D, Ribeiro JAS, Costa RA, et al. Intraoperative bleeding during vitrectomy for diabetic tractional retinal detachment with versus without preoperative intravitreal bevacizumab (IBeTra study). Br J Ophthalmol. 2009;93:688–91.Google Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Ulrich Spandau
    • 1
  • Heinrich Heimann
    • 2
  1. 1.University Eye HospitalUppsalaSweden
  2. 2.Royal Liverpool University HospitalLiverpoolUK

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