The cause and treatment of vitreous rebleeding after vitrectomy for proliferative diabetic retinopathy

Abstract

Objective To study the causes of vitreous reaccumulation of blood after vitrectomy for proliferative diabetic retinopathy (PDR), and to analyze the corresponding treatment methods. Methods The clinical data of 30 cases (30 eyes) of PDR in the Department of Ophthalmology of Chifeng Second Hospital of Inner Mongolia from April 2016 to 2017 were selected for 4 menstruation. Vitrectomy was performed in all patients with vitreous reaccumulation of blood. All the patients with vitrectomy with vitrectomy after PDR were analyzed, and the therapeutic effect was observed and the prognosis was observed. 23 cases (23 eyes) with normal intraocular pressure and no retinal detachment were treated with conservative treatment. They were given oral or intramuscular injection of hemostatic drugs and Chinese herbs for promoting blood circulation and removing blood stasis. 7 cases (7 eyes) with retinal detachment were treated with vitreoretinal surgery. Results The reason for PDR patients in postoperative vitreous body hematocele and vitreous body symptoms are mainly in the following aspects, three channel resection of sclera incision in the vitreous body neovascularization occurred in 10 cases (10 eyes), the total number of eyes 33.33%; 5 cases (5 eyes) of residual membrane vascular stump hemorrhage, the total number of eyes 16.67%; retinal or optic disc neovascularization and hemorrhage in 8 cases (8 eyes), the total number of eyes 26.67%; 3 cases (3 eyes) of retinal vein occlusion, the total number of eyes 10.00%; 4 cases (4 eyes) of otherwise unexplained patients, the total number of eyes 13.33%. Time with vitreous body hematocele and different patients with vitreous body after resection, 14 cases (14 eyes) a week after surgery, the total number of eyes 46.67% after silicone oil removal; concurrent 6 cases (6 eyes), the total number of eyes 20.00% after silicone oil removal; 1 months with 5 cases (5 eyes), the total number of eyes 16.67%; 3 months after silicone oil removal with 5 cases (5 eyes), the total number of eyes 16.67%. All patients were followed up. 6 months after treatment, 23 cases (23 eyes) were conservatively treated. 20 cases (20 eyes) had no blood loss. 3 cases (3 eyes) who had no conservative treatment were required to undergo vitreoretinal surgery. In 7 cases (7 eyes) with retinal detachment, all blood disappeared after vitreoretinal surgery. Conclusion The main reason for PDR patients complicated with vitreous body after resection of vitreous body hematocele three channel and resection of sclera incision in vitreous body, residual neovascularization membrane vascular stump hemorrhage, retinal hemorrhage or disc neovascularization and retinal vein occlusion, clinically according to the specific circumstances of the patients for targeted treatment, in order to improve the prognosis in patients. Key words: Proliferative diabetic retinopathy; Vitrectomy; Vitreous reaccumulation of blood