Anterior proliferative vitreoretinopathy in trauma and complicated retinal detachment. A histopathologic study

Anterior vitreoretinal proliferations are frequent sequelae of retinal detachment repair and severe trauma. Cellular proliferations can form membranes extending anteriorly from the peripheral retina. These membranes have the capability to contract and may lead to detachment of both the peripheral retina and, in more advanced stages, the ciliary body. Because the vitreous base and vitreous remnants are leading structures for cellular proliferation, complete removal of the anterior vitreous base in particular is important in cases of severe trauma or complicated retinal detachment. In 11 cases of anterior proliferative vitreoretinopathy examined histopathologically, we found overlying membranes and cellular infiltration of the vitreous in close correlation with the amounts of vitreous remnants present. Visualization of the peripheral retina and pars plana can rarely be accomplished in the presence of the crystalline lens or pseudophakia. Therefore, the removal of the anterior vitreous is often incomplete. To achieve complete dissection of the anterior vitreous, we remove even a clear lens during the first surgical intervention in selected cases.