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Efficiency of vitrectomy with removal of posterior hyaloid membrane in patients with cystoid macular edema occurring after phacoemulsification

Poster Details

First Author: Y.Razhko BELARUS

Co Author(s):    A. Barash   A. Kryvun           

Abstract Details



Purpose:

To characterize the effects of vitrectomy with removal of the posterior hyaloid membrane (PHM) in patients with cystoid macular edema (CME) with vertical traction that developed after phacoemulsification (Irvine-Gass syndrome).

Setting:

Ophthalmology Department, Republican Research Center for Radiation Medicine and Human Ecology, Gomel, Belarus

Methods:

A prospective, pilot study was conducted on eight eyes (8 patients) with a diagnosis of CME with vertical traction, which underwent ophthalmologic examinations including visual acuity and macular morphology assessment by optical coherence tomography (OCT). All patients were male, mean age - 67.4±7.2 years. In all cases there was a rupture of the posterior capsule of the lens with a partial loss of the vitreous during cataract surgery. All patients receiving standard anti-inflammatory therapy of CME was performed 25G three-port pars plana vitrectomy with removing PHM and internal limiting membrane (ILM) peeling in the area of vitreomacular adhesion.

Results:

There was a mean significant improvement in visual acuity and retinal thickness at 1, 4 and 12 weeks postsurgical period compared with baseline (p<0.05). The increase in visual acuity ranged from 2 to 4 lines. Mean (±SD) central macular thickness by OCT was 517.4±58.71 μm, 370.6±56.11, 219.1±19.38 and 194.5±25.50 μm at baseline, 1, 4 and 12 weeks of follow-up, respectively (p<0.05). Foveola thickness decreased respectively by 27.7 %, 57.8% and 62.2% from baseline. Baseline macular volume was 11.83±0.87 mm3, and after vitrectomy it decreased by 10.1%, 40.2% and 42.3 %, respectively (p<0.05). Macular thickness and volume changes were positively correlated (p<0.01) with visual acuity changes. Long-term postoperative complications were not revealed. The limitations of our study were the small number of observations and the lack of a control group that did not allow for statistical analysis in full.

Conclusions:

The 25G three-port pars plana vitrectomy with the PHM removal and ILM-peeling is pathogenetically substantiated technology and effective method of the surgical treatment of the CME with vitreomacular adhesion and vertical traction that appeared after phacoemulsification. We revealed decrease in volume and thickness of the retina with significant improvement in visual function after vitrectomy in patients with Irvine-Gass syndrome. FINANCIAL INTEREST: NONE

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