Le Mer Y, Des Beauvais T, Raynaud J F, Ribeaudeau F
Centre Hospitalier Intercommunal André Grégoire, Montreuil.
J Fr Ophtalmol. 1996;19(5):369-73.
To present clinical and therapeutic features of anterior fibrovascular proliferation, a severe complication of vitrectomy for diabetic retinopathy.
Among 153 vitrectomies for complication of diabetic proliferative vitreo-retinopathy, six cases of anterior fibro-vascular proliferation were found. All presented initially with a tractional retinal detachment associated in some cases with a vitreous hemorrhage. The complication occurred after a mean follow-up of three months after initial vitrectomy, marked by intravitreal bleeding, rubeosis iridis and hypotony. A reoperation with peeling of proliferation, lensectomy, extensive panretinal photocoagulation, encircling band and silicone oil injection allowed reattachment of the anterior retina in all the six cases.
A reproliferation occurred in five cases, requiring revision of dissection. Finally, silicone oil was removed in three cases, was definitively left in one eye and was not removed in two eyes. Final visual acuities range from 1/50 to 2/10.
Anterior fibrovascular proliferation is an unfrequent complication after vitrectomy for diabetic retinopathy. The prognosis is poor, in spite of aggressive vitreoretinal surgery including repeated dissection and extensive photocoagulation.
介绍前部纤维血管增殖这一糖尿病性视网膜病变玻璃体切除术后的严重并发症的临床及治疗特点。
在153例因糖尿病性增殖性玻璃体视网膜病变并发症而接受玻璃体切除术的患者中，发现6例发生前部纤维血管增殖。所有患者最初均表现为牵拉性视网膜脱离，部分病例伴有玻璃体积血。该并发症在初次玻璃体切除术后平均3个月出现，表现为玻璃体内出血、虹膜红变和低眼压。6例患者均通过增殖膜剥除、晶状体切除、广泛全视网膜光凝、环扎带及硅油注入等再次手术实现了前部视网膜复位。
5例出现再增殖，需要再次进行剥离手术。最终，3例患者取出了硅油，1例患者硅油永久留存，2例患者未取出硅油。最终视力范围为1/50至2/10。
前部纤维血管增殖是糖尿病性视网膜病变玻璃体切除术后少见的并发症。尽管采取了包括反复剥离和广泛光凝在内的积极玻璃体视网膜手术，预后仍较差。
