Selective Anterior Hypophysectomy in the Treatment of Diabetic Retinopathy

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Abstract
On the basis of Houssay's phenomenon and of Poulsen's report of a patient who had a selective necrosis of the anterior lobe of the hypophysis with a permanent cure of the diabetic retinopathy, it would seem that the most physiologic approach to the treatment of progressive diabetic retinopathy would be a selective and complete anterior hypophysectomy. In order to accomplish this, a microsurgical technique for dissection of the hypophysis through a transsphenoidal midline approach was developed and used in 17 consecutive cases. A selective anterior hypophysectomy was achieved in 11 patients. The other six patients had a total hypophysectomy. Significant reduction in the insulin requirements occurred in all of the patients. Diabetes insipidus occurred in six patients. Within the follow-up period of a few months to two years, it appeared that diabetic retinopathy might have been favorably influenced in 15 patients.

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