Ikeda T, Sawa H, Koizumi K, Yasuhara T, Kinoshita S, Tano Y
Department of Ophthalmology, Kyoto Prefectural University of Medicine, Japan.
Retina. 1998;18(5):410-4. doi: 10.1097/00006982-199805000-00004.
To characterize the clinical features of proliferative diabetic retinopathy (PDR) with asteroid hyalosis treated by pars plana vitrectomy.
Vitrectomy was performed in 26 eyes with PDR accompanied by asteroid hyalosis (7 eyes with vitreous hemorrhage, 6 eyes with tractional retinal detachment with vitreous hemorrhage, and 13 eyes with tractional retinal detachment without vitreous hemorrhage). We observed the occurrence of posterior vitreous detachment intraoperatively and evaluated the clinical characteristics retrospectively.
In 24 eyes, posterior vitreous detachment was slight, necessitating artificial detachment. Of the 26 eyes, 20 experienced iatrogenic retinal breaks and 6 (23%) experienced postoperative retinal detachment due to iatrogenic breaks. Three cases worsened to anterior proliferative vitreoretinopathy and retinal reattachment could not be achieved.
In vitrectomy for PDR with asteroid hyalosis, and in cases of simple vitreous hemorrhage, surgery should be performed with full understanding of the anatomic characteristics. Notably, if posterior vitreous detachment is not present, the occurrence of iatrogenic retinal breaks is more likely.
描述经玻璃体切割术治疗的伴有星状玻璃体病变的增殖性糖尿病视网膜病变（PDR）的临床特征。
对26例伴有星状玻璃体病变的PDR患者的眼睛进行玻璃体切割术（7例伴有玻璃体积血，6例伴有牵引性视网膜脱离合并玻璃体积血，13例伴有牵引性视网膜脱离但无玻璃体积血）。我们术中观察了玻璃体后脱离的发生情况，并回顾性评估了临床特征。
24只眼中玻璃体后脱离较轻，需要人为分离。26只眼中，20只发生医源性视网膜裂孔，6只（23%）因医源性裂孔发生术后视网膜脱离。3例病情恶化为前部增殖性玻璃体视网膜病变，无法实现视网膜复位。
在对伴有星状玻璃体病变的PDR进行玻璃体切割术时，对于单纯玻璃体积血的病例，手术应在充分了解解剖特征的情况下进行。值得注意的是，如果不存在玻璃体后脱离，发生医源性视网膜裂孔的可能性更大。
