WOUND COMPLICATIONS IN PARS-PLANA VITRECTOMY

Eighteen eyes with examples of clinically important wound-related comp lications are reported. These include hemorrhage, fibrous ingrowth, an d tractional or mechanical problems. Wound hemorrhages may occur early or late and can be the cause of substantial morbidity. Furthermore, i ntraocular blood is undesirable because it may provoke cataract format ion, contribute to the postvitrectomy fibrin syndrome, induce fibrovas cular proliferation, and lead to further surgery to remove the blood. Fibroplasia at the wound sites may in some patients contribute to the development of anterior hyaloid fibrovascular proliferation. Fibrous i ngrowth may occur early or late and may be self-limited, with few side effects, or florid, with progression to retinal detachment or phthisi s bulbi. Dilation of subconjunctival blood vessels entering the incisi on site suggests the presence of fibrous ingrowth or fibrovascular pro liferation occurring in the vitreous base. Tractional or mechanical pr oblems include retinal breaks, which may or may not lead to retinal de tachment, and scarring within the vitreous base, which may contribute to the formation of anterior vitreoretinal traction or anterior prolif erative vitreoretinopathy.