R. Grewing et U. Mester, EARLY VITRECTOMY FOR PROGRESSIVE DIABETIC PROLIFERATIONS COVERING THEMACULA, British journal of ophthalmology, 78(6), 1994, pp. 433-436
The clinical course in 50 eyes was analysed after pars plana vitrectom
y for progressive diabetic fibrovascular proliferations. Patients were
assigned to pars plana vitrectomy if progression of proliferations oc
curred despite a photocoagulation treatment with a mean number of 3500
burns and additional peripheral cryoablation. All cases had visual im
pairment because of fibrovascular tissue covering the macula without d
etachment of the macula. Flat proliferations were present in all eyes
without retinal elevation, vitreous detachment, or vitreous haemorrhag
e. The follow up intervals ranged from 13 months to 39 months (mean in
terval 24 months). Twelve months postoperatively, 36 eyes (72%) showed
improved visual acuity, five eyes (10%) were worse, and nine eyes (18
%) were unchanged. Thirty two eyes (64%) achieved final visual acuity
of 0.2 or better, and 45 eyes (90%) gained 0.05 or better. In only two
eyes could reproliferation be observed. The postoperative course indi
cates that pars plana vitrectomy for diabetic fibrovascular proliferat
ions covering the macula can preserve socially useful visual acuity of
at least 0.05 in most cases.