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F. Kuhn; Uveitis: An Indication for Pars Plana Vitrectomy?. Invest. Ophthalmol. Vis. Sci. 2009;50(13):3568.
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Uveitis often requires long-term systemic corticosteroid and/or immunosupressive therapy, which can cause major secondary complications. A study was conducted to evaluate the indications for, and efficacy of, vitrectomy for uveitis.
Pars plana vitrectomy with or without internal limiting membrane peeling in a consecutive series of 24 eyes in 20 patients.
In addition to severe macular edema being present in 60% of eyes, no fewer than 24% eyes had retinal detachment at the time of vitrectomy. Following surgery, the visual acuity improved an average of 4.8 lines in 80% of eyes. Vision was lost in one eye, due to rapidly progressing proliferative vitreoretinopathy. All patients were able to stop their systemic corticosteroid/immunosupressive therapy since uveitis recurred in no eye.
The risk of a major complication of surgery is very low while the benefits include a decent chance for visual improvement and a significant chance of removing the need for systemic antiinflammatory/anti-immune therapy, with their marked rate of secondary complications. Early consideration for vitrectomy should be part of our armamentarium for uveitis of various etiologies.
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