ANTERIOR FIBROVASCULAR PROLIFERATION - AN UNUSUAL COMPLICATION AFTER DIABETIC VITRECTOMY

Purpose To present clinical and therapeutic features of anterior fibro vascular proliferation, a severe complication of vitrectomy for diabet ic retinopathy. Methods Among 153 vitrectomies for complication of dia betic proliferative vitreo-retinopathy, six cases of anterior fibro-va scular proliferation were found. All presented initially with a tracti onal retinal detachment associated in some cases with a vitreous hemor rhage. The complication occurred after a mean follow-up of three month s after initial vitrectomy, marked by intravitreal bleeding, rubeosis iridis and hypotony. A reoperation with peeling of proliferation, lens ectomy, extensive panretinal photocoagulation, encircling band and sil icone oil injection allowed reattachement of the anterior retina in al l the six cases. Results A reproliferation occurred in five cases, req uiring revision of dissection. Finally, silicone oil was removed in th ree cases, was definitively left in one eye and was not removed in two eyes. Final visual acuities range from 1/50 to 2/10. Conclusion Anter ior fibrovascular proliferation is an unfrequent complication after vi trectomy for diabetic retinopathy. The prognosis is poor, in spite of aggressive vitreoretinal surgery including repeated dissection and ext ensive photocoagulation.