Long term Follow up of Pars Plana Vitrectomy for Vitreomacular Traction Syndrome

Abstract

Abstract: : Purpose: To assess long term visual and anatomical outcomes following pars plana vitrectomy (PPV) with release of vitreomacular traction (VMT). Methods: A retrospective medical records review of 26 eyes with symptomatic vision loss and/or distortion secondary to VMT was performed. All eyes underwent PPV and had >18 months postoperative follow up. Two eyes had VMT without macular pucker or full–thickness macular hole (FTMH), 19 eyes had an associated macular pucker, and 5 eyes had a FTMH secondary to the VMT. Results: Follow up ranged from a minimum of 18 months to 65 months (mean 35 months). Visual acuity (VA) improved from a mean of 20/140 preoperatively to a final mean of 20/80 (mean number of lines of visual improvement was 4). Eighty–four percent of eyes had stable or improved final VA; 54% halved their visual angle; and, 62% had a mean 35 month VA of >20/40. Fifteen percent had a mean 35 month VA of <20/100, compared to 62% with preoperative VA of <20/100. The most significant complication was increased lens opacity (94% of phakic eyes). Other complications included recurrent macular pucker in 2 eyes, FTMH in 2 eyes, and retinal detachment in 1 eye. Conclusions: Long term follow up after PPV to release VMT with and without associated macular pucker and/or FTMH demonstrated stable or improved VA in 84% of eyes. It has been reported that 64% of eyes with VMT had a further deterioration in vision of >2 lines without vitrectomy intervention. Long term follow up of vitrectomized eyes after release of VMT in this study yielded similar outcomes as previous reports on the same subject with short term follow up.

Keywords: vitreoretinal surgery • macula/fovea • retina