YAN Hua , XU Yinghai
  • Department of Ophthalmology, Tianjin Medical University General Hospital, Tianjin 300052, China;
Dabetic retinopathy/surgery; Vitrectomy; Vitreous hemorrhage/etiology; Postoperative complications/prevention & ; control
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Objective To analyze the pathogeny of vitreous re-hemorrhage in proliferative diabetic retinopathy (PDR) after vitrectomy, and to evaluate the treatment effects. Methods The clinical data of 315 eyes of 302 patients with PDR who had undergone vitrectomy were retrospectively analyzed. Thirty-two eyes with vitreous re-hemorrhage after the treatment had undergone vitrectomy again. The follow-up duration was 3-48 months (average 12 months). Results The occurrence of vitreous hemorrhage after vitrectomy was 10%. The reasons included fibrovascular ingrowth at the sclera incision (28%), residual neovascularization membrane or inappropriately treated vascular stump on the surface of optic nerve (19%), insufficient photocoagulation on retina (22%), residual epiretinal neovascularization membrane (9%), retinal vein occlusion (6%), and ocular trauma (16%). Re-hemorrhage occurred 1-210 days (average 51 days) after vitrectomy. The patients with re-hemorrhage underwent cryotherapy for fibrovascular at the incision site, removal of residual neovascularization membrane on the optic nerve and retina, electrocoagulation of the vascular stump, complementary retinal photocoagulation and binding up of two eyes. After the re-treatment, the visual acuity increased in 91% and decreased in 9%. The postoperative complications mainly included vitreous re-hemorrhage, posterior synechia of the iris, lens sclerosis, and delayed healing of corneal epithelium. Conclusion The main reasons of vitreous re-hemorrhage after vitrectomy in patients with PDR include fibrovascular ingrowth at sclera incision, residual neovascularization membrane or inappropriately treated vascular stump on the surface of optic nerve, insufficient photocoagulation on retina, residual epiretinal neovascularization membrane, retinal vein occlusion, and ocular trauma. The efficient methods in preventing and treating re-hemorrhage after vitrectomy are appropriate management of insection sites, completely removal of residual neovascularization membrane on the optic nerve and retina, electrocoagulation of the vessel stump and sufficient retinal photocoagulation. (Chin J Ocul Fundus Dis,238-240)

Citation： YAN Hua,XU Yinghai. Pathogeny and treatment of vitreous re-hemorrhage in proliferative diabetic retinopathy after vitrectomy. Chinese Journal of Ocular Fundus Diseases, 2007, 23(4): 238-240. doi: Copy