Surgical Results in the Vitreomacular Traction Syndrome

Abstract

The vitreomacular traction syndrome is a distinct clinical entity in which partial posterior vitreous detachment is present in combination with persistent macular adherence, causing traction-induced visual deficit. The authors evaluate the results of vitreous surgery for this syndrome. The authors reviewed 20 consecutive eyes that underwent vitrectomy and posterior hyaloid/epiretinal membrane stripping to better define the clinical features, visual results, and complications of surgery for the vitreomacular traction syndrome. Eyes were categorized anatomically as having either "classic" vitreomacular traction syndrome (8 [40%] eyes had 360 degrees midperipheral vitreous detachment) or "variable" vitreomacular traction syndrome (12 [60%] eyes had a variety of midperipheral areas of vitreous separation). Release of vitreomacular traction resulted in improvement in vision of two or more lines in 15 (75%) eyes, with 8 (40%) obtaining 20/50 visual acuity or better. All eyes were followed for at least 6 months. Complications of vitreous surgery included progression of nuclear sclerosis (83% of phakic eyes), epiretinal membrane formation (40%), and retinal breaks (20%). The vitreomacular traction syndrome represents a wide spectrum of vitreoretinal anatomic configurations that can produce visual deficit. Vitrectomy surgery to release macular traction may improve visual acuity.