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O. M. Biscette, T. Flynn, W. Schiff, S. Chang, G. Barile; Vitrectomy Outcomes In Patients With Noninfectious Uveitis. Invest. Ophthalmol. Vis. Sci. 2007;48(13):5157.
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To examine the ocular outcomes of vitreoretinal surgery in the management of patients with non-infectious uveitis.
Retrospective, non-comparative, interventional study of the clinical records of 25 patients (27 eyes) with chronic, noninfectious uveitis who underwent vitreoretinal surgery at the New York Presbyterian Hospital between January 1996 and December 2005. Preoperative data analyzed included: patient demographics; clinical diagnosis, diagnostic labs, medications and prior surgeries, and complete ocular examination including best corrected visual acuity (BCVA), papillary exam, slit lamp biomicroscopy, applanation tonometry, and vitreous, fundus optic nerve examination. Surgical data included indication for the operation, intraoperative medications, and complications. Postoperative data included systemic ocular medications, BCVA ever achieved, and BCVA at the end of the follow-up period.
The average follow up period was 41 (4-98) months. The mean age was 44.2 (3-78) years. Figure 1 shows the change in the preoperative, best postoperative, and end of follow up LogMAR visual acuity. The LogMAR visual acuity improved from an average of 1.71 (20/1000) prior to surgery to 0.81 (20/125) at the end of the follow up period and 0.67 (20/94) as the best achieved visual acuity during the follow up period. At the end of the follow up period there, the anterior chamber reaction was decreased in 50% of eyes, increased in 8% of eyes, and unchanged in 42%. Fifty percent of eyes continued to require long-term immunosuppression; 50% had a reduction in the number of immunosuppressive medications and 33% needed and increase in the number of immunosuppressive medications. There was a systemic diagnosis in 37.5% of patients. Fifty seven percent of phakic patients required cataract surgery during the postoperative period.
Pars plana vitrectomy is often associated with improvement in visual acuity, reduced anterior chamber reaction and reduced need for immunosuprressive medications in eyes with noninfectious uveitis. Phakic eyes usually require cataract surgery in the post-vitrectomy period to achieve final best corrected visual acuity.
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