Cemil Apaydin, Yusuf Akar, Mustafa Unal, Koray Demir, Meryem Guler, Pinar Tavas (Antalya, Turkey)

Advantages:

The importance and effect of vitrectomy in patients with vitreomacular traction syndrome (VMTS).

Methods:

31 eyes of 29 patients with macular edema due to VMT who underwent vitrectomy to relieve macular traction are reviewed retrospectively. The diagnosis of VMT was based on the findings of clinical examination and optical coherence tomography (OCT). Preoperative and postoperative best-corrected visual acuity results were converted to logarithm of the minimal angle of resolution visual acuity for analysis. Eyes with less than 6 months follow-up were excluded. Eyes were divided into three groups with respect to the relationship of the posterior hyaloid to the retina. Group 1: focal vitreofoveal hyaloidal attachment with perifoveal separation; Group 2: vitreoretinal hyaloidal attachment to the macula and papillomacular bundle; and Group 3: broad vitreofoveal attachment with a fine epiretinal membrane over the posterior pole.

Results:

Mean preoperative intraocular pressure was 14 +/- 3.5 mmHg. At the final follow-up, mean intraocular pressure was 14.5 +/- 2.7 mmHg, which did not differ significantly from the intraocular pressure at baseline (P = 0.14, two-tailed t-test). The mean follow-up was 10.3 +/- 2.2 months (range, 6-15 months). Twelve eyes (39%) were pseudophakic and 19 (61%) were phakic at the time of surgery.  Fourteen eyes were in Group 1 while 8 and 9 eyes were in Group 2 and group 3, respectively. Twenty-three eyes (69.9%) had at least 1 line of improvement in visual acuity. Improvement in vision was significantly greater in the eyes in Group 1 (2.46 +/- 1.12 lines) and in Group 2 (1.78 +/- 1.34 lines) then Group 3 (1.06 +/- 1.01 lines; P = 0.01). Visual outcome correlated with symptom duration (P = 0.04), preoperative central macular thickness and VMT category (all three Groups). A decrease in mean CMT was also significantly correlated with VMT configuration (Group 1, 2, or 3; P = 0.0 2).

Effectiveness / Safety:

Vitrectomy has been applied successfully in the surgical treatment of patients with VMTS.

Take home message:

Duration of symptoms, preoperative central macular thickness. Visual outcome after vitrectomy for VMT is correlated with preoperative vitreomacular structure.