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J.Y. Choi, C. Kafkala, C.S. Foster; Pars Plana Vitrectomy versus Immunomodulatory Therapy in a Prospective Randomized Trial for Treatment of Pars Planitis . Invest. Ophthalmol. Vis. Sci. 2005;46(13):2830.
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To determine whether pars plana vitrectomy (PPV) is superior to immunomodulatory therapy (IMT) for patients with pars planitis.
Patients diagnosed with pars planitis which persisted despite regional steroid injections and had degraded the visual acuity of the affected eye were randomized to receive either PPV or IMT. After vitrectomy or IMT initiation, outcome measures were measured pre– and postoperatively at 6–month intervals for up to 18 months. These measures were best–corrected Snellen visual acuity, intraocular pressure (IOP), cataract formation, anterior chamber and vitreous cellular infiltrate and presence of cystoid macular edema (CME). Results were analyzed with Student’s T–test.
Sixteen patients (20 eyes) were randomized to the PPV (9 patients, 11 eyes) or the IMT group (7 patients, 9 eyes). Patients included 12 females and 4 males aged 7 to 77 years (mean 33 yrs). There were no intraoperative complications associated with PPV. Greater than expected leukopenia and anemia in one patient each were the only IMT complications, both of which resolved. Nine of 11 eyes (82%) treated with PPV showed resolution of inflammation by the end of follow–up. Six of 11 eyes (55%) given IMT had persistent inflammation and required subsequent PPV. Number of Snellen lines improvement, IOP change and improvement in anterior and vitreous cell (graded 1+–4+) are presented in the table at 6, 12 and 18 months’ follow–up.
A higher percentage of patients treated with PPV had resolution of uveitis compared to those given IMT. Over half of IMT eyes eventually required PPV. There were no statistically significant differences in visual outcomes for either group for up to 18 months afterward.
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