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M. E. Patron, A. J. Witkin, L. C. Castro, E. Reichel, A. H. Rogers, C. R. Baumal, J. S. Duker; Surgical Outcomes of Vitrectomy for Vitreomacular Traction Syndrome. Invest. Ophthalmol. Vis. Sci. 2009;50(13):6051.
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To assess anatomic and visual outcomes after pars plana vitrectomy for vitreomacular traction syndrome.
The charts of 746 patients who had pars plana vitrectomy surgery with membrane peel from January 2002 to December 2007 at Tufts Medical Center were reviewed. Twenty-four eyes of 24 patients diagnosed with vitreomacular traction (VMT) syndrome by optical coherence tomography (OCT) were identified and evaluated. All 24 eyes underwent elevation of the posterior hyaloid with 12 eyes (50%) having concomitant epiretinal membrane (ERM) peel. Patient data, visual acuities, OCT findings, and foveal thicknesses were recorded.
Patients were followed for a mean of 27.6 months (range = 0.7 to 68.3 months) after surgery. Mean visual acuity improved from 20/134 preoperatively to 20/76 postoperatively (p = 0.0063). Eighteen of 24 eyes (75%) had 1 or more lines of improvement and 8/24 (33%) had 3 or more lines of improvement in Snellen visual acuity. Mean central macular thickness on OCT decreased from 407.52 µm preoperatively to 256.13 µm postoperatively (p = 0.0001). Eleven eyes (46%) regained a normal foveal contour by OCT, 7 (29%) had residual ERM, 4 (17%) developed lamellar macular defects, and 1 (4%) developed a full-thickness macular hole.
Vitrectomy appears to be effective in improving visual acuity in eyes with vitreomacular traction syndrome. In our experience, while successful in relieving traction at the vitreomacular interface, surgery results in a normal foveal contour in less than half of patients. The remainder of patients often retains some abnormality at the vitreomacular interface.
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