[Anterior fibrovascular proliferation. A rare complication of vitrectomy for proliferative diabetic retinopathy]

Abstract

Purpose: To present clinical and therapeutic features of anterior fibrovascular proliferation, a severe complication of vitrectomy for diabetic retinopathy.

Methods: Among 153 vitrectomies for complication of diabetic proliferative vitreo-retinopathy, six cases of anterior fibro-vascular proliferation were found. All presented initially with a tractional retinal detachment associated in some cases with a vitreous hemorrhage. The complication occurred after a mean follow-up of three months after initial vitrectomy, marked by intravitreal bleeding, rubeosis iridis and hypotony. A reoperation with peeling of proliferation, lensectomy, extensive panretinal photocoagulation, encircling band and silicone oil injection allowed reattachment of the anterior retina in all the six cases.

Results: A reproliferation occurred in five cases, requiring revision of dissection. Finally, silicone oil was removed in three 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: Anterior fibrovascular proliferation is an unfrequent complication after vitrectomy for diabetic retinopathy. The prognosis is poor, in spite of aggressive vitreoretinal surgery including repeated dissection and extensive photocoagulation.