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Wolfgang F. Schrader, Martin Vetterle; Long Term Results After Pars Plana Vitrectomy For Terson’s Syndrome. Invest. Ophthalmol. Vis. Sci. 2011;52(14):3600.
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Intracranial hemorrhages are followed by vitreous hemorrhages in 5% (Terson’s Syndrome). A pars plana vitrectomy (PPV) is performed, when the vitreous hemorrhage persists or tractions develop. It is believd that PPV will ease the further neurological rehabilitation. The retrospective study was carried out to analyze the long term anatomical and functional results and the further neurological development.
We retrospectively analyzed the records of 32 patients, who had surgery for Terson’s syndrome between Jan 1, 1996 and April 30th, 2004, mostly as an outpatient procedure. Data were gathered 1 to 3 yrs following PPV in our department, from the referring neurological department and from the neurologists and ophthalmologists who cared for the follow up of the patient.
PPV was performed 12,2 weeks (mean) after the intracranial hemorrhage. 11/32 patients developed bilateral hemorrhages, 6 had bilateral PPV, 5 died due to neurological complications, before the PPV could be carried out in the second eye. Visual acuity rose from LogMAR 1,9 preoperatively (equal to fingercounting) to LogMAR 0,551 (equal to Snellen VA 0,3) 6 months after surgery, and to LogMAR 0,148 at 1 year. and LogMAR 0,179 (each is about 0,7) 3 years following surgery. PPV enabled rapid further neurological rehabilitation: preoperatively 63% could neither walk with or without assistance and had to rely on a wheel chair. Only 39% had to do so at 6 weeks postop, 36% at 6 months postop, 32% at 1 year and 30% at 3 years.
PPV for Terson’s syndrome can be successfully performed as an outpatient procedure with a low complication rate. We could show, that the eye surgery accelerates the neurological rehabilitation process. This is an argument for early vitrectomy which has been underestimated so far.
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