[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%).