23G vitrectomy outcomes of macular edema in retinal vein occlusion combined with vitreomacular traction or epiretinal membrane / 国际眼科杂志(Guoji Yanke Zazhi)

AIM:To evaluate 23G vitrectomy for macular edema in eyes with retinal vein occlusion (RVO) combined with vitreoretinal traction (VMT) or epiretinal membrane (ERM).METHODS:Totally 22 patients (22 eyes) diagnosed with macular edema of RVO combined with VMT or ERM were retrospectively analyzed.Twelve cases performed with 23G vitrectomy together with peeling of inner limiting membrane (ILM) and/or ERM were considered as the observation group or intervention group.Ten cases without vitrectomy were recruited as control group.The best corrected visual acuity (BCVA) and central retinal thickness (CRT) at baseline, 1, 3 and 6mo were recorded and compared.RESULTS:At baseline, the difference of BCVA and CRT between observation group and control group was not statistically significant (P=0.645, 0.206).After vitrectomy, the BCVA and CRT of RVO patients in observation group were significantly improved compared with baseline at each follow-up (F=2.895, P=0.048;F=16.431, P<0.01).However, the BCVA and CRT in control group remained the same as baseline at every follow-up.Moreover, the BCVA and CRT in observation group were much better than that in control group at both 3 and 6mo after vitrectomy.However, the BCVA and CRT between two groups were not significantly different at 1mo postoperatively.CONCLUSION:The 23G vitrectomy could markedly improve BCVA and reduce CRT in RVO patients with macular edema combined with VMT and/or ERM.

Clinical Evaluation for Patients with Retinal Detachment Caused by Macular Hole

We investigated the surgical outcomes in 19 eyes with retinal detachment(RD)caused by macular hole only. 15 eyes were high-myopic(>-8.0Ds), and the mean preoperative axial-length was 28.30 mm. As an initial treatment method, simple gas injection was done to 2 eyes, and pars plana vitrecto-my(PPV), air-fluid exchange and subretinal fluid drainage with intravitreal tamponade were performed in 17 eyes. The retina of 2 eyes with simple gas injection was not attached because of persistent vitreoretinal traction. PPV with intravitreal tamponade was successful in 12 of 17 eyes with a single operation, and reoperation was effective in 3 eyes of the failed 5 eyes. We conclude that, in case of retinal detachment caused by macular hole, the success rate can be improved by PPV with complete removal of vitreoretinal traction along with the long-lasting intravitreal tamponade.

Surgical Prognostic Factors in Proliferative Diabetic Retinopathy(PDR)

The results of diabetic vitrectomy on eyes with severe proliferative fibrovascular membranes are often disappointing, because of difficulties in removing the membranes. But we sometimes observe the regression of the proliferative fibrovascular membranes when the antero-posterior tractional force become released. Hence we compared the surgical prognosis of proliferative diabetic retmopathy according to the severity of proliferation and whether removal of antero-posterior vitreoretinal traction was complete or not. The results showed that the anatomic success rate and final visual acuities(VA) were significantly better in less-severe proliferation group(LSPG) than in severe prolif era tion group(SPG). In SPG, the anatomic success rate and VA tended to be better when we were able to remove the antero-posterior vitreoretinal adhesion completely whether the removal of preretinal membranes was complete or not. When complete removal of the diabetic fibrovascular membrane is difficult due to severe proliferation and broad adhesion, complete removal of anter-posterior traction only could be an alternative in diabetic vitrectomy.