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G. F. Graue-Moreno, C. Lizana, S. Voorduin-Ramos, J. Rodriguez, M. Pedroza-Seres; Diagnostic and Therapeutic Vitrectomy for Uveitis Management. Invest. Ophthalmol. Vis. Sci. 2008;49(13):5964. doi: https://doi.org/.
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To asses the outcome and possible benefits of Pars Plana Vitrectomy (PPV) for diagnostic and therapeutic purposes in patients with uveitis.
Eighteen patients (22 eyes) from eight men and ten women between 6 and 79 years (standard deviation 21.55 years, average 29.5 years) were included.Previous clinical diagnosis were: Pars planitis (4), Vogt-Koyanagi-Harada syndrome (6 ), ocular toxoplasmosis (2), masquerade syndrome (2), Eales disease (1), ocular syphilis (1), panuveitis in HIV patients (3) and idiopathic panuveitis (3).Seven eyes underwent PPV, 4 eyes PPV plus phacoemulsification, 9 eyes PPV plus lensectomy, 1 eye PPV with lensectomy plus scleral buckling and 1 eye PPV and scleral buckling.Indications for PPV were as follow: uveitic cataract and persistent vitreous opacity(11), uveitic cataract and refractary macular edema(1), rhegmatogenous retinal detachment(4), persistent vitreous hemorrhage (2) and vitreous opacities associated with persistent visual loss (4).PCR was positive for cytomegalovirus in both eyes from a patient with panuveitis associated with HIV (+). Histopathological analysis of vitreous tap in one patient was positive for intraocular lymphoma. Candida albicans was positive in two HIV (+) patients with panuveitis .Patients showed an improvement in visual acuity in 80% of cases after surgery (p<0.05). This improvement was sustained during the follow-up in more than fifty percent of the patients. Complications of PPV were: persistent hypotony (one eye), recurrent retinal detachment (one eye), ocular hypertension and persistent inflammation (1 eye).
PPV alone or combined with other surgical procedures is effective and safe in controling inflamation in patients with uveitis.
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