July 2018
Volume 59, Issue 9
Free
ARVO Annual Meeting Abstract  |   July 2018

Managing focal vitreomacular traction with pneumatic vitreolysis, an emerging surgical technique
Author Affiliations & Notes
  • Martha Henao
    Ophthalmology , Loma Linda University, Loma Linda, California, United States
  • Calvin Mein
    Retinal Consultants of San Antonio, San Antonio , Texas, United States
    Ophthalmology , University of Texas Health , San Antonio , Texas, United States
  • Moises Chica
    Retinal Consultants of San Antonio, San Antonio , Texas, United States
  • Gary Lane
    Retinal Consultants of San Antonio, San Antonio , Texas, United States
  • Clement K Chan
    Southern California Desert Retina Consultants, Palm Desert , California, United States
  • Footnotes
    Commercial Relationships   Martha Henao, None; Calvin Mein, Alcon (F), Allergan (F), Iconic (F), Ophthotech (I), Regeneron (I), ThromboGenics (F); Moises Chica, Alcon (F), Allergan (F), NEI (F), Ora (F); Gary Lane, Alcon (F), Allergan (F), Ora (F); Clement Chan, Allergan (F), Genentech (F), NEI (F), Ophthotech (F), Regeneron (F), Sequenom (F)
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science July 2018, Vol.59, 5268. doi:https://doi.org/
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    • Get Citation

      Martha Henao, Calvin Mein, Moises Chica, Gary Lane, Clement K Chan;
      Managing focal vitreomacular traction with pneumatic vitreolysis, an emerging surgical technique. Invest. Ophthalmol. Vis. Sci. 2018;59(9):5268. doi: https://doi.org/.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To assess the benefits and risk of pneumatic vitreolysis (PVL) for treating vitreomacular traction (VMT) with or without stage-2 macular holes (MH).

Methods : We performed a retrospective study on patients with focal VMT who underwent PVL in 2 centers from 2010 to 2017. All patients were required to avoid supine position after receiving 0.3 mL C3F8 gas injection until gas resolution. Patients with MH were asked to maintain face-down for at least 4 days. Best-spectacle corrected visual acuity (BSCVA) was performed at baseline and at each follow-up visit.

Results : Sixty-nine consecutive eyes in 68 patients with VMT (47 women; mean age of 70.7 [range: 48-85]) underwent PVL. Overall VMT release was achieved in 59 eyes (85.5%) within a mean of 2.9 weeks. Subgroup analysis showed VMT release in 79.2% of VMT-only eyes, but up to 95% of eyes with MH. 61.9% of MH closed. Subsequent vitrectomy closed all failed MH. Median baseline and final BSCVA was 0.3979 ±0.213 and 0.24 ± 0.173 (20/50 and 20/350, respectively (p<0.0001).Younger age and lack of diabetes were strongest predictors for success. Complications (7.2%) included retinal tears in 2 eyes, retinal detachment in 2 eyes, and VMT progressing to MH in 1 eye; all responded to treatment. One eye developed unusual persistent loculated submacular fluid

Conclusions : VMT with PVL and limited face-down is a highly effective emerging technique for achieving VMT release (86%) for focal VMT, with a respectable MH closure rate of 62%. The overall BSCVA was significantly better at final visit than baseline. One eye developed atypical post-gas injection eccentric loculated subretinal fluid bleb

This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.

 

Image 1: Baseline before gas injection

Image 1: Baseline before gas injection

 

Image 2: 1 week post injection (Top) and 6 months post injection (Bottom)

Image 2: 1 week post injection (Top) and 6 months post injection (Bottom)

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