Vitrectomy in Complicated Pars Planitis

ABSTRACT

Consecutive twelve patients' twelve eyes with complicated pars planitis underwent pars plana vitrectomy at our center in the period from January 1988 to December 1990. Patients' ages ranged from 24 to 60(mean 39.9)years and all were male. Nine patients had histories of topical or systemic steroid therapy and at the time of surgery, all eyes were quiet from active inflammation. With various degrees of vitreal opacities, five eyes had macular pucker or membrane only and in other seven eyes, retinal detachments of either tractional or tractional-rhegmatogenous origin were arisen. In the later group, macular hole was associated in two eyes. Surgical procedures combined were membrane peeling(five eyes), scleral buckling(ten eyes), fluid/air-gas exchange(eight eyes), lensectomy(two eyes) and photocoagulation(two eyes). During the follow-up period ranged from four to twenty-one(mean 7.75)months after first operations, the uveitis recurred or continued to be activated in four eyes and as a complication, retinal detachment occurred in two eyes which had macular pucker only preoperatively. One refused reoperation and the other was reattached successfully by second operation. Final visual acuities were improved in eight eyes, stationary in one and worsen in three. The causes of worsen vision were retinal detachment, macular edema and macular slanting by buckle respectively. Preoperatively, the majority of eyes(10 eyes 84%) had less than 0.09 vision and postoperative vision turned over better than 0.09 in 7 eyes(59%). Although we did not confirm extinguished therapeutic effects of vitrectomy on the pars planitis perse, our results revealed some positve role of surgical intervention in the complicated pars planitis.