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D.S. Kjellgren; Vitrectomy For Vitreous Amyloidosis in Umea University Hospital 1989-2001 - A Retrospective Study . Invest. Ophthalmol. Vis. Sci. 2003;44(13):3019.
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Purpose: To study the outcome of pars plana vitrectomy (PPV) for vitreous opacification due to familial amyloidotic polyneuropathy (FAP). Methods: From 1989 to 2001 PPV was performed on 29 eyes of 21 patients with FAP and vitreous amyloidosis at Umea University hospital. Diagnosis was obtained by biopsy and/or molecular genetic technique. Mean follow up time was 3 years. Results: There were 14 women and 7 men. The mean age at vitrectomy was 77 years (range 57-85 years). Seven patients died during the time of follow up. One refused further controls. Seven of the eyes were pseudophakic prior to vitrectomy. Five eyes had a combined procedure with Phaco, PCL and PPV at primary vitrectomy. Fifteen eyes had cataract surgery during follow up. Repeat vitrectomy due to reopacification was required in 12 cases and in one case a third vitrectomy was performed. Of the 12 eyes with prior or combined cataract surgery only one required repeat vitrectomy. One eye had an intraoperative retinal break requiring cryotherapy. One eye had a retinal detachment that was successfully treated with scleral buckling. Glaucoma developed in nine eyes. Glaucoma filtering surgery was performed in two cases. One eye had a postoperative intraocular bleeding with high IOP. A vitrectomy was performed successfully but due to persisting glaucoma visual acuity remained at 0.02. Mean preoperative visual acuity was 0.04. Mean best postoperative visual acuity was 0.65, but mean final visual acuity was 0.24 due to glaucoma in most cases. Conclusions: Vitrectomy is effective in treating patients with vitreous amyloidosis, but severe glaucoma is frequently seen postoperatively. Reoperation rates can be lowered if cataract surgery is performed prior to or combined with vitrectomy.
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