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Matteo G. Cereda, Niels Hoevenaars, Marc Veckeneer, Jan C. vanMeurs, Tom Missotten; The Effect Of Pars Plana Vitrectomy On Macular Edema Sustained By Macular Pucker In Uveitis Patients: Long Term Results. Invest. Ophthalmol. Vis. Sci. 2012;53(14):1186.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the efficacy of pars plana vitrectomy with peeling of epiretinal membrane and internal limiting membrane (PPVP) in the management of chronic uveitic macular edema (CME) sustained by macular pucker.
Retrospective study. 34 eyes of 34 patients with CME and macular pucker secondary to chronic intermediate or posterior uveitis unresponsive to medical treatment underwent PPVP. The primary outcome was change in visual acuity (VA) at 1, 2, 3, 4, 5 and more than 5 (>5) years after surgery. Secondary outcomes measures: change in mean thickness of the central fovea area (1 mm of diameter) as measured on OCT (Stratus; Carl Zeiss Meditec, Dublin CA or RTVue-100; Optovue, Fremont CA) at preoperative examination and at last follow-up; changes in inflammation recorded as cell count in anterior chamber (ACc) and vitreous (Vc) at 1, 2, 3, 4, 5 and >5 years after surgery.
All 34 patients had at least 1 year follow up. 27/34 patients two years, 22/34 three years, 13/34 four years, 10/34 five years and 4/34 more than five years of follow-up. Compared to baseline (0,7 logMar SD±0,4) a significant gain in mean VA was found at 1 year (0,4 logMar SD±0,3) (Paired T Test: p<0,0001), 2 years (PreOp: 0,75 logMar SD±0,4 and PostOp: 0,35 logMar SD±0,3) (p<0,0001) and 3 years (PreOp 0,75 logMar SD±0,45 and PostOp 0,45 logMar SD±0,4) (p5 years of follow-up even if it was not statistically significant. Mean foveal thickness was 392 μm (SD±125μm) at preoperative examination and decreased to a mean of 276 μm (SD±54μm) at last follow-up (Paired T Test: p<0,001). Inflammation: ACc remained stable while Vc were statistically significant lower compared to ACc during the first 5 years of follow up (Wilcoxon: p<0,05 at 1, 2, 3, 4, 5 years).
PPVP in patients with macular edema and macular pucker secondary to chronic uveitis seems to have a significant beneficial effect on visual function at least up to 3 years of follow-up and on foveal thickness and vitreous haze up to 5 years after surgery.
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