Article
Results of pars plana vitrectomy technique in cases with macular edema
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Published: | September 18, 2006 |
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Outline
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Objective
The aim of the study is to show whether the performance of the pars plana vitrectomy (ppv) is beneficial in cases with macular edema.
Methods
The study that was done in the period between 2003-2005 incorporated 73 patients. Group A included 31 patients with macular edema (ME) due to diabetic retinopathy (DR), vein occlusion (VO), and age related macula degeneration (ARMD). The group B included 42 patients under same conditions like group A. The preoperative examination was performed by ophthalmoscopy, biomicroscopy and fluorescein angiography (FA). In the group A a ppv with three-port system, combined by posterior hyaloid membrane peeling was performed. The patients in group B were treated by “grid” LFK. The follow-up period was between 8-18 months.
Results
Resolution of the ME in group A was seen in 22/31 (70,9%) patients, persistent ME in 7/31 (22,5%), while worsening of the ME in 2/31 (6,4%) patients. In the group B resolution of the ME was seen in 20/42 (47,6%) patients, persistent ME in 12/42 (28,5%) patients, and worsening of the ME in 10/42 (23,8%) patients. Improvement of the visual acuity (VA) of 2 rows in Snellen lines in group A was seen in 19/31 (61,2%), and improvement of more then 4 rows was present in 5/31 (16,1%) patients. In the group B improvement of the (VA) of 2 rows was seen in 15/42 (35,7%) patients, while improvement of more then 4 rows was in 3/42 (7,1%) patients. The complications that followed the surgery in group A were : vitreal hemorrhage in 2/31 patients, and one patient developed macular hole. In one patient a epiretinal membrane was seen, while worsening of the lens opacification was seen in 8/31 patients.
Conclusions
Resolution of the macular edema and improvement of the VA in group A was significantly better then in group B. Improvement of the VA in the vitrectomy group may be due to shallow macular detachment from the posterior hyaloid traction, instead of ME, or both conditions can play role in it’s development.