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.