[Responsibility of incomplete retinal photocoagulation in the indication of vitrectomy in proliferative diabetic retinopathy].

PURPOSE: We report an epidemiologic study about prophylactic photocoagulation of ischaemic diabetic retinopathy in order to avoid proliferative stage and severe vitreous haemorraghe.

METHODS

We studied retrospectively 42 eyes of 32 diabetic patients who underwent a vitrectomy in 1993. For each patient several items were analyzed: nationality, sex, age, type, duration and clinical course of diabetes, and other risk factors. Slit lamp and ocular fundus examination were noted; in particular lens, iris and vitreoretinal framework.

RESULTS

Almost all patients had an inadequate laser photocoagulation: in 26 eyes (62%) it was insufficient or non-existent, uncomplete in 12 eyes (29%), and non confluent for 18 eyes (43%). Only four eyes have had complete and confluent panphotocoagulation.

CONCLUSION

Photocoagulation appears to be the priority therapy to avoid most severe complications of proliferative diabetic retinopathy. Laser photocoagulation must be started from preproliferative retinopathy, confluent on the useless ischaemic retinal areas, and dense elsewhere.