Vitrectomy in the Management of Vitreomacular Traction Syndrome

Abstract

Purpose: To estimate long-term results after vitrectomy with internal limiting membrane peeling in vitreomacular traction syndrome (VMTS), as well as to estimate factors influencing final visual outcome. Methods: Medical records of all patients who underwent pars plana vitrectomy for idiopathic VMTS from 2007 through 2015 were assessed. Spectral domain optical coherence tomography was performed preoperatively and at least 6 months after surgery. The mean horizontal and vertical diameters of the vitreomacular traction (VMT) were measured. The area of vitreomacular attachment was calculated. Results: Twenty-four eyes of 22 patients (mean age, 74 years) were included in this study. Mean visual acuity improved significantly from 0.26 Snellen (0.69 logMAR) to 0.39 Snellen (0.43 logMAR) in the mean of 29 months after surgery (7-90 months; median, 25 months; P = .02, paired t test). Visual acuity improved in 18 eyes, remained unchanged in 2 cases, and decreased postoperatively in 4 eyes. Multiple regression analysis did not reveal any factors significant for determining final visual acuity. However, when regrouping the patients according to the International Vitreomacular Traction Study Group, we observed that final visual acuities were statistically significantly better in eyes with focal vitreous detachment compared to broad vitreous detachment ( P = .04). Conclusions: Despite the fact that VMT is a 3-dimensional disease, the calculated area of attachment was not greater than the vertical diameter of attachment. According to the current study, the classification of VMT proposed by the VMT Study Group might be an important tool in predicting the final visual outcome after vitrectomy.