Treatment and observation of postvitrectomy diabetic vitreous haemorrhage in patients with PDR

Abstract

AIM: To discuss the treatment and to evaluate the therapeutic effect by reviewing a group of postvitrectomy diabetic vitreous haemorrhage(PDVH)cases after vitrectomy for proliferative diabetic retinopathy(PDR). METHODS: Retrospective analysis of 12 cases of 12 PDR patients with PDVH in our hospital from September 2015 to June 2017. First, conservative treatment was performed and then surgical treatments were performed on patients with large amount of bleeding and poor effect of conservative treatment(including anterior chamber flushing, vitreous lavage, vitrectomy, or combination of cataract surgery). The patients were observed and analyzed during and after surgeries. RESULTS: The mean duration between the first surgery and PDVH ranged from 1d to 10mo(mean 61.58±92.69d). The cases of early and late PDVH was 8 eyes and 4 eyes, respectively. Two eyes were treated with conservative treatment and the bleeding were absorbed after 2wk-1mo. Ten eyes without obvious improvement after treatment or intraocular pressure(IOP)increased again received surgical treatment, in which 2 eyes were treated with simple anterior chamber flushing, 8 eyes underwent vitreous lavage(2 eyes combined with cataract surgery, 1 eyes combined with silicone oil injection). Seven eyes received supplementary photocoagulation. Till the last follow-up, all vitreous haemorrhages resolved, and 9 eyes had better visual acuity. CONCLUSION: PDVH can be induced by various reasons and appropriate measures should be taken by regulating blood glucose, improving operative skills and timely symptomatic treatments to improve the visual acuity.

Keywords

• photocoagulation
• proliferative diabetic retinopathy
• vitrectomy
• vitrectomy