[Contribution of posterior hyaloid membrane to pathogenesis and transciliary surgery of proliferative diabetic retinopathy].

Results of 276 transcilliary vitrectomies in patients with proliferative diabetic retinopathy are analyzed. The indications for surgery were traditional in 180 patients and early in 98. The object of surgical manipulations in early surgery for proliferative diabetic retinopathy is the posterior hyaloid membrane, which should be detached from the retina and removed at an area as larger as possible. New vessels or fibrovascular tissue are left intact. After removal of the posterior hyaloid membrane they do not proliferate. Early surgery on the posterior hyaloid membrane in patients with proliferative diabetic retinopathy helps attain more stable and better functional results and involves a lesser number of serious intra- and postoperative complications. Fibrovascular proliferation does not progress after removal of the posterior hyaloid membrane at the site of the posterior pole of the eye, and therefore, we did not carry out panretinal laser coagulation during or after surgery. The only exceptions were cases with neovascularization of the iris in the postoperative period.