VITRECTOMY FOR PROLIFERATIVE DIABETIC RETINOPATHY WITH ASTEROID HYALOSIS

Purpose: To characterize the clinical features of proliferative diabetic retinopathy (PDR) with asteroid hyalosis treated by pars plana vitrectomy. Methods: Vitrectomy was performed in 26 eyes with PDR accompanied by asteroid hyalosis (7 eyes with vitreous hemorrhage, 6 eyes with tractional retinal detachment with vitreous hemorrhage, and 13 eyes with tractional retinal detachment without vitreous hemorrhage). We observed the occurrence of posterior vitreous detachment intraoperatively and evaluated the clinical characteristics retrospectively. Results: In 24 eyes, posterior vitreous detachment was slight, necessitating artificial detachment. Of the 26 eyes, 20 experienced iatrogenic retinal breaks and 6 (23%) experienced postoperative retinal detachment due to iatrogenic breaks. Three cases worsened to anterior proliferative vitreoretinopathy and retinal reattachment could not be achieved. Conclusions: In vitrectomy for PDR with asteroid hyalosis, and in cases of simple vitreous hemorrhage, surgery should be performed with full understanding of the anatomic characteristics. Notably, if posterior vitreous detachment is not present, the occurrence of iatrogenic retinal breaks is more likely.