Lewis H, Abrams G W, Williams G A
Department of Ophthalmology, Medical College of Wisconsin, Milwaukee.
Am J Ophthalmol. 1987 Dec 15;104(6):607-13. doi: 10.1016/0002-9394(87)90173-5.
Vitrectomy was performed to treat 74 consecutive eyes for complications of diabetic retinopathy. Eight (13%) of 61 eyes followed up for an average of 12 months developed anterior hyaloidal fibrovascular proliferation. This was the most common postoperative complication, whose features included recurrent hemorrhages into the vitreous cavity or anterior vitreous, or both; vessels or fibrovascular tissue on the posterior lens capsule; anterior extraretinal vascularization extending toward the lens on the anterior hyaloid; traction detachment of the peripheral retina or ciliary body; and hypotony. Patients who developed this complication tended to be young males with severe retinal neovascularization and extensive retinal ischemia; traction retinal detachment as an indication for surgery; placement of a scleral buckle; postoperative rubeosis iridis, recurrent vitreous hemorrhages, and retinal detachment; and multiple surgeries. Four eyes progressed to atrophia bulbi. Early recognition followed by additional surgery in two patients and extensive additional photocoagulation in two other patients was successful in preserving good visual function.
对74只连续的眼睛进行玻璃体切除术以治疗糖尿病视网膜病变的并发症。在平均随访12个月的61只眼中,有8只(13%)出现了前玻璃体纤维血管增殖。这是最常见的术后并发症,其特征包括玻璃体腔或前玻璃体反复出血,或两者皆有;晶状体后囊膜上的血管或纤维血管组织;前玻璃体上朝向晶状体延伸的视网膜前血管化;周边视网膜或睫状体的牵引性脱离;以及低眼压。发生这种并发症的患者往往是年轻男性,有严重的视网膜新生血管和广泛的视网膜缺血;牵引性视网膜脱离作为手术指征;巩膜扣带的放置;术后虹膜红变、反复玻璃体出血和视网膜脱离;以及多次手术。4只眼睛发展为眼球萎缩。两名患者早期识别后进行额外手术,另外两名患者进行广泛的额外光凝,成功地保留了良好的视功能。