Outcomes Of Pars Plana Vitrectomy Research Articles

Retinal detachments secondary to inferior retinal breaks: anatomic outcomes following the use of different surgical techniques

PurposeTo compare the anatomical and functional outcomes of pars plana vitrectomy (PPV) alone versus PPV with the addition of a scleral buckle in treating inferior rhegmatogenous retinal detachments (RRDs).MethodsComparative, retrospective...

Thirteen year experience of vitrectomy and air tamponade for primary retinal detachment repair with clinical outcomes.

To report outcomes of pars plana vitrectomy (PPV) with air tamponade for primary rhegmatogenous retinal detachment (RRD) and investigate the impact of vitreous cortex remnants (VCR) on surgical outcomes. A retrospective review of 900 patients treated for uncomplicated primary RRD between 2007 and 2020. Exclusion criteria included axial length > 26mm, prior retinal surgery, giant retinal tear, PVR grade > B, and inadequate follow-up. Primary outcomes were retinal reattachment rate and best-corrected visual acuity (BCVA). Of 900 patients, 397 met inclusion criteria. Primary reattachment rate was 88.4%, with significant BCVA improvement. Forty-six eyes experienced RRD recurrence. Complications included cataracts (38.8%), IOP rise (11.4%), and macular edema (8.3%). Better final BCVA was associated with preoperative macular non-involvement and absence of reinterventions. No significant association was found between RRD recurrence and various factors, including VCR removal. Air tamponade is a safe and effective option for primary RRD treatment. It has no negative effect on the environment and creates less discomfort for patients. VCR removal did not significantly reduce RRD recurrence in the overall number of cases. Further research will help determine the role of VCR in RD recurrence and define in which cases their removal might be beneficial.

Clinical Characteristics of Proliferative Diabetic Retinopathy and Outcome of Pars Plana Vitrectomy in Proliferative Diabetic Retinopathy.

Proliferative diabetic retinopathy is a leading cause of blindness among people with diabetes. The study aimed to assess the clinical characteristics of proliferative diabetic retinopathy and outcome of pars plana vitrectomy in Proliferative diabetic retinopathy. A prospective study was conducted from September 2019 to December 2021 among consecutive cases of proliferative diabetic retinopathy who underwent pars plana vitrectomy at a tertiary eye care center. Study was conducted after ethical approval from Institutional Review Committee. Detailed systemic and ocular history, visual acuity, ocular findings under mydriasis, surgical procedures, and outcome following pars plana vitrectomy were recorded. Cases were followed up regularly until one year after the pars plana vitrectomy. Total of 83 cases (89 eyes) of proliferative diabetic retinopathy were enrolled in the study. The mean age was 53 years ±9.7 SD, ranging from 26 years to 72 years. Males comprised of 62.7% cases. Type two diabetes comprised of 94% of cases. Indications for pars plana vitrectomy were; mixed vitreous hemorrhage and tractional retinal detachment (38.2%), non-clearing vitreous hemorrhage (38.1%), and tractional retinal detachment only (24.7%). Pre-operative intra-vitreal anti-vascular endothelial growth factor was given in 78.65% eyes and pan retinal photocoagulation in 58.42% eyes. The anatomical success was achieved in 95.5% eyes, visual improvement in 68.54%, static in 14.6% and worsened in 16.86% of eyes. About 15.7% of eyes had some form of post- operative complications. Vitreous hemorrhage with tractional retinal detachment, persistent vitreous hemorrhage and tractional retinal detachment involving macula were the common indication of pars plana vitrectomy among cases of Proliferative diabetic retinopathy. Anatomical success and visual acuity improvement can be achieved in majority of the eyes following PPV in Proliferative diabetic retinopathy.

Impact of drainage retinotomy on surgical outcomes of retinal detachment: insights from the Japan-Retinal Detachment Registry

We investigated the impact of drainage retinotomy on the outcome of pars plana vitrectomy for repair of rhegmatogenous retinal detachment (RRD). This study was a retrospective observational multicenter study. All patients were registered with the Japan-Retinal Detachment Registry. We analyzed 1887 eyes with RRD that had undergone vitrectomy and were observed for 6 months between February 2016 and March 2017. We compared the baseline characteristics and postoperative outcomes between eyes with and without drainage retinectomy. We then performed propensity score matching using preoperative findings as covariates to adjust for relevant confounders. Of 3446 eyes, 1887 met the inclusion criteria. Among them, 559 eyes underwent vitrectomy with drainage retinotomy, and 1328 eyes underwent vitrectomy without drainage retinotomy. After propensity score matching, each group comprised 544 eyes. There was no significant difference between the two groups in BCVA at 6 months after vitrectomy (0.181 vs. 0.166, P = 0.23), the primary anatomical success rate (6.3% vs. 4.4%, P = 0.22), or the rate of secondary surgery for ERM within 6 months (1.5% vs. 1.3%, P = 1.0). Drainage retinectomy does not increase the risk of decreased postoperative BCVA, surgical failure, or secondary surgery for ERM within six months outcomes.

Outcomes of different surgical procedures for optic disc pit: a meta-analysis

Objective To assess the surgical outcomes of pars plana vitrectomy (PPV) in conjunction with various adjuvant procedures for optic disc pit maculopathy (ODPM). Methods We conducted a literature search to identify clinical studies and case series of surgically treated OPM patients. (1) greater than two patients, (2) surgical treatment and (3) reporting of pre and postoperative visual acuity data were inclusion criteria. We excluded review articles and studies unavailable in the English language. One-way analysis of variance, Pearson’s chi-squared test and straightforward linear regression were used to analyze the results. Results A total of 838 studies were initially identified as potentially relevant studies. After removing duplicates and screening titles and abstracts, the eligibility of 86 full-text articles was evaluated. There were 50 studies included in the meta-analysis. We identified the following commonly reported techniques: juxtapapillary laser alone, PPV alone or with juxtapapillary laser (PPV/JPL), internal limiting membrane peeling (PPV/ILMP), both ILMP and JPL (PPV/ILMP/JPL), inner retinal fenestration (PPV/IRF), autologous platelet concentrate (PPV/APC), macular buckling alone or with PPV, PPV with ocriplasmin (PPV/OCR) and PPV with autologous scleral flap. All groups showed an improvement in best-corrected visual acuity compared with baseline, with no significant differences between groups. The average OPM resolution rate for all groups was 70% (range: 56–100%), and the average resolution duration was 9.1 months. Central macular thickness was diminished in the PPV, PPV/JPL, and PPV/ILMP groups, but there were no significant differences between groups. There was no effect on the outcomes. Analyses of linear regression revealed significant correlations between preoperative best-corrected visual acuity and the aforementioned outcome measures. The rate of complete anatomic success and visual improvement following PPV is ∼85%. Anatomic and visual success rates for PPV alone are 89% and 100%, respectively, according to subgroup analysis. Gas tamponade, laser and ILMP during vitrectomy are less promising, whereas PPV with ILM flap stuffing may yield better results than cases without it. Conclusion We did not find a significant difference in functional outcomes between the various surgical procedures used to treat OPM. Based on the available evidence, PPV is effective for ODPM, while gas tamponade, laser and ILMP should be used with caution. This study is limited by its reliance on retrospective studies and publication bias towards positive outcomes.

Outcomes of pars plana vitrectomy in the management and diagnosis of patients with infectious, non-infectious, and unidentified uveitis

PurposeTo present the outcomes of pars plana vitrectomy (PPV) in patients with infectious, non-infectious, and unidentified uveitis, focusing on visual and clinical outcomes, diagnostic yield, and surgery-related complications.MethodsThis retrospective, single-center study included patients who underwent 23-gauge PPV for the management of uveitis and had at least 6 months of follow-up. Patients were divided into infectious, non-infectious, and unidentified uveitis groups based on definitive diagnosis after surgery. Etiologies of uveitis, indications for surgery, diagnostic yield, visual outcomes, presence of cystoid macular edema (CME), immunosuppressive drugs, intraoperative and postoperative complications, and repeated vitrectomies were reviewed.ResultsThis study included 62 eyes of 54 patients. Twenty eyes were diagnosed with infectious uveitis, 24 eyes with non-infectious uveitis, and 18 eyes with unidentified uveitis. The diagnostic yield of vitrectomy was 41.7%. Mean BCVA significantly improved at postoperative 1 month compared to baseline and remained stable at following time-points in all groups. The most common early postoperative complication was increased intraocular pressure (17%), and late complication was cataract (36%). Nine eyes underwent re-vitrectomy and the most common cause was retinal detachment with proliferative vitreoretinopathy (PVR).ConclusionPPV seems to be effective in diagnosing cases of unknown origin, improving visual acuity, and reducing the need for systemic immunosuppressive drugs. PVR is the most serious complication with poor prognosis that requires repeated surgery in patients with uveitis.

Comparison of pars plana vitrectomy and combined pars plana vitrectomy with phacoemulsification for proliferative diabetic retinopathy: A retrospective study about 120 eyes.

To compare the outcomes of pars plana vitrectomy (PPV) and combined PPV with phacoemulsification (PPVCE) surgeries for proliferative diabetic retinopathy (PDR) and cataract treatment. Retrospective analysis of 120 diabetic patients who underwent PPV or PPVCE. The key outcome indicators were best-corrected visual acuity (BCVA) and post-operative complications. The PPVCE group had an average age of 53 years, with 50% females and 50% males. The initial visual acuity (VA) was 1.84 log MAR. In this group, BCVA remained stable or increased in 61 eyes (74%). Regarding the PPV group, the average age was 43 years; 65% were men while 34% were women. The initial VA was 1.83 log MAR; in this group, the VA increased or remained stable in 28 eyes (73%). The evolution of the VA was rather symmetric in the two groups without a significant difference (P = 0.9). Similarly, the occurrence of postoperative complications was comparable for the main complications studied, namely the inflammatory reaction (P = 0.809), ocular hypertension (P = 0.344), corneal edema (P = 0.07), and neovascular glaucoma (P = 0.413). However, there was a decrease in BCVA (three lines) in the PPV group after 6 months of follow-up (P = 0.05) in patients with a clear lens preoperatively and who developed a clinically evident cataract. According to this study, for diabetic patients with severe cataracts and vitreoretinal disease requiring vitrectomy, combining vitrectomy with phacoemulsification as a single surgical intervention may be a suitable therapeutic choice. This approach does not significantly increase the risk of visual impairment or retinopathy development.

Visual and Anatomical Outcomes of Pars Plana Vitrectomy for Dropped Nucleus

Objective: To evaluate the visual and anatomical outcomes of pars plana vitrectomy (PPV) in patients with dropped nucleus following complicated phacoemulsification (PE).
 Materials and Methods: A retrospective study was conducted at the Ophthalmology Department of Lahore General Hospital, Lahore between 2017 and 2022. The study included 51 patients (33 males and 18 females) between the age 35 to 85 years who were referred after a complicated phacoemulsification with dropped nucleus.
 Results: This study included 51 patients in which 33 were males (64.71%) and 18 were females (35.29%). All patients underwent 23-gauge pars plana vitrectomy. Posterior chamber phacofragmentation was carried out in 32 (62.75%) eyes while in remaining 19 (37.25%) patients vitrectomy cutter was used for the dropped nucleus. Out of 51, 06 (11.76%) patients received an anterior chamber IOL at the time of cataract surgery, 21 (41.18%) eyes had IOL in the ciliary sulcus, 07 (13.73%) had a posterior chamber IOL, and the remaining 17 (33.33%) patients were aphakic. Of these 17 aphakic patients, an anterior chamber IOL was placed at the time of vitrectomy in 07 (41.18%) patients who were judged to have inadequate capsular support for a posterior chamber lens. In the remaining 10 (58.82%) eyes, where capsular support was deemed adequate, a posterior chamber IOL was inserted. Final visual acuity was 20/40 or better in 34 (66.67%) eyes and 20/50 in 06 (11.76%) patients.
 Conclusion: Poor visual outcome after dropped nucleus at phacoemulsification cataract extraction can be avoided if managed by prompt pars plana vitrectomy as it offers the advantages of a closed system for vitrectomy and manipulation of the nucleus, an improved view of the posterior segment and facilitated recognition and management of intraoperative complications with better visual and anatomical outcomes with low rate of postoperative complications.

Comparison of anatomical and functional outcomes of pars plana vitrectomy for rhegmatogenous retinal detachment with phaco-vitrectomy

Comparison of anatomical and functional outcomes of pars plana vitrectomy for rhegmatogenous retinal detachment with phaco-vitrectomy

Outcomes of Pars Plana Vitrectomy With Membrane Peel for Lamellar Macular Holes and Related Conditions Using a New Optical Coherence Tomography Consensus Definition.

Purpose: To characterize the change in visual acuity (VA) in eyes treated with vitrectomy using the 2020 international consensus-based optical coherence tomography (OCT) definition of lamellar macular hole (LMH), macular pseudohole (MPH), and epiretinal membrane with foveoschisis (ERMF). Methods: A retrospective chart review was performed from 2000 to 2022 of patients who had vitrectomy for symptomatic decreased VA from LMH, MPH, or ERMF performed by the same surgeon at a community hospital. Preoperative spectral domain (SD-OCT) was reviewed to classify patients using the consensus guidelines. Primary outcomes were the mean change in best-corrected VA at 3 months, 1 year, and the final postoperative examination. Results: Fifty-one patients were included, 30 with LMH, 14 with MPH, and 7 with ERMF. The VA was 20/63 at baseline, 20/62 (P = .79) 3 months postoperatively, 20/40 (P = .003) at 1 year, and 20/52 (P = .10) at the final examination for LMH; 20/64, 20/50 (P = .16), 20/40 (P = .040), and 20/40 (P = .02), respectively, for MPH; and 20/53, 20/50 (P = .42), 20/30 (P = .03), and 20/38 (P = .04), respectively, for ERMF. Subgroup analysis showed that eyes with LMH without ellipsoid zone (EZ) disruption on SD-OCT improved from 20/57 at baseline to 20/39 (P = .01) at the final examination. Conclusions: There was no significant improvement in VA at the final postvitrectomy examination in eyes with LMH, while there was significant improvement in eyes with MPH and ERMF. This supports surgery in selected eyes with MPH and ERMF but possibly not in eyes with LMH, unless OCT shows no EZ disruption.

Comparison of anatomical and functional outcomes of different surgical techniques in myopic macular hole without retinal detachment.

To define the anatomic and functional outcomes of pars plana vitrectomy (PPV) with internal limiting membrane (ILM) peeling, inverted ILM flap and free ILM patch graft technique for the treatment of myopic macular hole (MH) without retinal detachment. Sixty-four eyes of 64 patients who underwent PPV for myopic MH were included. Group 1 consists of patients underwent ILM peeling (n=26), and Groups 2 and 3 consists of patient underwent free ILM patch graft (n=20) and inverted ILM flap procedure (n=18) respectively. Outcomes following surgery were MH closure and best corrected visual acuity (BCVA) in logMAR at 6mo. Closure of MH was obtained in 20 eyes (76.9%) of the Group 1, in 16 eyes (80%) of the Group 2 and in 16 eyes (88.9%) of the Group 3. The mean preoperative and postoperative BCVA was 1.60±0.53 logMAR and 1.27±0.58 logMAR, respectively (P<0.05). There was no significant difference in the postoperative BCVA and anatomical closure rates in the three groups. Although the anatomical closure rate did not differ significantly in the groups, closure of MH tended to be better in the inverted ILM flap technique group at 6mo. Different surgical techniques may provide favorable visual and anatomical results for myopic MH surgery. ILM flap techniques offer higher closure rates compared to ILM peeling technique. However, in terms of visual outcomes, the study reveals no difference in three surgical techniques.

Efficacy of Vitrectomy With Tamponade Versus No Tamponade for Myopic Traction Maculopathy: A Multicenter Study (SCHISIS Report No.1)

To evaluate the influence of tamponade on the visual and anatomic outcomes of pars plana vitrectomy for myopic traction maculopathy (MTM). Multicenter, retrospective clinical cohort study. Consecutive eyes that underwent vitrectomy for advanced MTM with tamponade of air, sulfur hexafluoride (SF6), or perfluoropropane (C3F8) or without tamponade with a minimum follow-up of 12 months were included. Main outcome measures included postoperative visual acuity (VA) at 12 months in eyes with vs without tamponade. We included a total of 193 eyes (193 patients) in this study; 136 eyes (70%) treated with tamponade were compared with 57 eyes (30%) treated without tamponade. Baseline characteristics did not differ significantly between the groups. Both groups showed significant visual improvement at 12 months (both P < .001). However, postoperative visual acuity and visual improvement at 12 months were significantly better (P=.003 and P=.028, respectively) in eyes without tamponade, although the MTM in these eyes without tamponade took longer to resolve (P=.039). Retinal thickness and the ellipsoid zone were more preserved in eyes without tamponade (P < .001 and P=.001, respectively). Complications such as macular holes did not differ between the groups. A novel imaging finding of "schisis bending (accordioning)" was identified during MTM resolution. Vitrectomy either with or without tamponade for MTM was effective in improving vision in this study. However, eyes without tamponade experienced even better visual improvement and preserved retinal anatomy, despite a longer schisis resolution time. Surgery without tamponade may achieve better visual outcomes.

VITRECTOMY FOR VITREOUS HEMORRHAGE ASSOCIATED WITH RETINAL VEIN OCCLUSION: Visual Outcomes, Prognostic Factors, and Sequelae.

To report the outcomes of pars plana vitrectomy for vitreous hemorrhage (VH) associated with retinal vein occlusion and to identify prognostic indicators. Interventional, retrospective consecutive case series between 2015 and 2021. The study included 138 eyes of 138 patients (64 female and 74 male); 81 patients had branch retinal vein occlusion and 57 had central retinal vein occlusion. The mean age was 69.8 years. The mean duration between the diagnosis of VH and surgery was 79.6 ± 115.3 (range, 1-572) days. The mean follow-up was 27.2 months. The logarithm of the minimum angle of resolution visual acuity significantly improved from 1.95 ± 0.72 (Snellen equivalent, 20/1782) to 0.99 ± 0.87 (20/195) at 6 months and to 1.06 ± 0.96 (20/230) at the final visit (both P < 0.001). The visual acuity at 6 months improved by three or more lines in 103 eyes (75%). Postoperative complications during follow-up included recurrent VH in 16 eyes (12%) (of which 8 eyes underwent reoperations), rhegmatogenous retinal detachment in six eyes (4%), and new neovascular glaucoma in three eyes (2%). Worse final visual acuity was significantly associated with older age ( P = 0.007), concurrent neovascular glaucoma ( P < 0.001), central retinal vein occlusion ( P < 0.001), worse preoperative visual acuity ( P < 0.001), postoperative new neovascular glaucoma ( P = 0.021), and postoperative retinal detachment ( P < 0.001). The duration of VH was not associated with visual outcomes ( P = 0.684). Preoperative antivascular endothelial growth factor injections and tamponade did not prevent postoperative recurrent VH. Pars plana vitrectomy is effective for VH associated with retinal vein occlusion, regardless of the duration of hemorrhage. However, pre-existing risk factors and postoperative sequelae may limit visual recovery.

Anti-vascular endothelial growth factors in combination with vitrectomy for complications of proliferative diabetic retinopathy.

Anti-vascular endothelial growth factors in combination with vitrectomy for complications of proliferative diabetic retinopathy.

Effect of Macular Internal Limiting Membrane Peeling on Single Surgery Success Rates of Vitrectomy for Uncomplicated, Primary Macula-Off Retinal Detachment.

Purpose: To determine the anatomic and visual outcomes of pars plana vitrectomy for uncomplicated, primary macula-off rhegmatogenous retinal detachment (RRD) with and without internal limiting membrane (ILM) peeling. Methods: This retrospective chart review comprised 129 patients with uncomplicated, primary macula-off RRD presenting between January 1, 2016, and May 31, 2021. Thirty-six patients (27.9%) had ILM peeling and 93 (72.0%) did not. The primary outcome was the rate of recurrent RRD. Secondary outcomes included preoperative and postoperative best-corrected visual acuity (BCVA), epiretinal membrane (ERM) formation, and macular thickness. Results: No significant difference was found in the risk for recurrent RRD between patients who had ILM peeling and those who did not (2.8% [1/36] and 5.4% [5/93], respectively) (P = 1.00). The final postoperative BCVA was better in eyes that did not have ILM peeling (P< .001). No ERM occurred in the group with ILM peeling, whereas ERM occurred in 27 patients (29.0%) who did not have ILM peeling. The temporal macular retina was thinner in eyes in which ILM peeling was performed. Conclusions: The risk for recurrent RRD was not statistically lower in eyes having ILM peeling of the macula in uncomplicated, primary macula-off RRD. Despite a reduction in postoperative ERM formation, eyes having macular ILM peeling had worse postoperative VA.

Outcomes of Pars Plana Vitrectomy with Panretinal Photocoagulation for Treatment of Proliferative Diabetic Retinopathy Without Retinal Detachment: A Seven-Year Retrospective Study.

To review clinical outcomes of patients with proliferative diabetic retinopathy (PDR) and vitreous hemorrhage (VH) who underwent pars plana vitrectomy (PPV) with endolaser panretinal photocoagulation (PRP) without retinal detachment (RD) repair. Retrospective chart review of the rate of postoperative clinical findings and visual acuity in patients with PDR from May 2014 to August 2021. Pars plana vitrectomy with endolaser PRP was performed in 81 eyes of 81 patients (mean age of 62.1 ± 10.5 years). At a median follow-up of 18 months, mean Snellen best-corrected visual acuity (BCVA) significantly improved from 20/774 preoperatively to 20/53 at last follow-up (P < 0.001). Postoperative complications and clinical findings included VH (12.3%), diabetic macular edema (DME) (12.3%), ocular hypertension (8.6%), RD (4.9%), and need for additional PPV (6.2%). Eyes with PRP performed within 6 months before surgery had a lower frequency of developing postoperative VH (5.3%) compared to eyes that received PRP more than 6 months before surgery (27.3%, P = 0.04). Eyes that received preoperative anti-vascular endothelial growth factor (VEGF) treatment (2.0%) had a lower frequency of postoperative VH compared to eyes that did not receive anti-VEGF treatment (14.3%, P = 0.04). Eyes that received intraoperative sub-tenon triamcinolone acetonide developed postoperative DME (4.0%) less frequently than eyes that did not receive sub-tenon triamcinolone acetonide (26.7%, P = 0.04). In patients with PDR and VH, PPV with PRP yielded significant improvements in visual acuity and resulted in overall low rates of recurrent postoperative VH. Preoperative anti-VEGF and PRP laser treatment were associated with lower rates of postoperative VH. Furthermore, intraoperative use of sub-tenon triamcinolone acetonide was associated with a lower rate of postoperative DME. Pars plana vitrectomy with endolaser PRP in conjunction with the aforementioned pre- and intraoperative therapies is an effective treatment for patients with PDR and VH.

The Effect of Combining Scleral Buckle Surgery with Pars Plana Vitrectomy for Treatment of Recurrent Retinal Detachment Secondary to Proliferative Vitreoretinopathy.

The objectiove of the study is to evaluate and compare the outcomes of pars plana vitrectomy (PPV) and PPV combined with scleral buckle (SB) in vitrectomised cases with recurrent retinal detachment (RD) and to analyze the effects of adding SB to the procedure. Patients with recurrent RD due to grade C proliferative vitreoretinopathy (PVR) were included in this retrospective comparative case series. Patients who underwent re-PPV with or without SB were included and two groups (re-PPV; re-PPV+SB) were compared in terms of anatomical and functional success. Sixty-five cases were included in the study: 32 underwent re-PPV and 33 underwent re-PPV+SB procedures. Reattachment was achieved in 59.4% of the re-PPV group versus 81.8% of the re-PPV+SB group (p=0.047). Although preoperative BCVA was worse in the re-PPV+SB group (p=0.005), postoperative BCVA at the last visit was similar in both groups (p=0.065). In the treatment of recurrent RD with grade C PVR, combining the SB procedure with PPV contributes to anatomical and functional outcomes.

Functional and Anatomical Outcomes of Pars Plana Vitrectomy for Epiretinal Membrane in Patients with Uveitis.

Purpose-To evaluate the anatomical and functional outcomes of vitrectomy and epiretinal membrane (ERM) peeling in patients with uveitis. Secondarily, we evaluated the effect of internal limiting membrane (ILM) peeling on surgical outcomes, and of surgery on uveitis activity and, thus, therapeutic regime. Methods-Bicentre, retrospective, interventional case series of 29 eyes of 29 consecutive patients affected by uveitis and ERM, that had undergone pars plana vitrectomy with ERM peel between 2012 and 2020, with a minimum postoperative follow-up (FU) of six-months. Demographic data, best-corrected visual-acuity (BCVA), clinical findings, intraoperative and postoperative complications, and macular optical-coherence-tomography scans were reviewed. Results-The mean (standard deviation) duration of follow-up was 32 (22) months. At six-month FU, mean central-retinal-thickness (CRT) significantly improved (from 456 (99) to 353 (86) microns; p &lt; 0.001), and mean BCVA improved from 0.73 (0.3) to 0.49 (0.36) logMAR (p &lt; 0.001), with only one (3%) patient experiencing worsening of vision. The rate of concomitant cystoid macular edema decreased from 19 (66%) eyes at presentation to eight (28%) eyes at final-FU (p = 0.003). Comparing eyes in which ILM peeling was performed in addition to ERM peeling only, BCVA or CRT reduction were comparable. Only a minority of six (21%) eyes had a worsening in uveitis activity requiring additional medications, whereas most patients resumed the same treatment (52%) or received less treatment (28%) (p = 0.673). Conclusions-Vitrectomy with ERM peeling led to favourable anatomical and functional outcomes in patients with uveitis regardless of whether the ILM is peeled or not. As in most patients, no activation of the uveitis requiring additional medications was noted, we do not recommend changes in anti-inflammatory/immunosuppressive therapy postoperatively.

Anatomical and functional outcomes of RETINOTOMY on primary inferior RHEGMATOGENOUS retinal detachment

AbstractPurpose: To analyse the anatomical and functional outcomes of pars plana vitrectomy combined with retinotomy alone in primary inferior rhegmatogenous retinal detachments (RD).Methods: Data from 139 patients who underwent vitreoretinal surgery for inferior RD in Centro Hospitalar Vila Nova de Gaia/Espinho, between 2012 and 2021 by the same surgeon, were analysed. Univariate and multivariate analysis were performed. Outcomes such as visual acuity (VA) and occurrence of complications were studied.Results: From the total 139 eyes analyse, 72 were subject to vitrectomy combined with retinotomy. Among them, 79% had macula‐off at the time of surgery and 94.4% had proliferative vitreoretinopathy (grade B or C). Functional success, with VA improvement or stabilization after surgery, was 75%. VA was significantly improved from 1.61 to 0.73 logarithm of the minimal angle of resolution units (p &lt; 0.001). The anatomic success rate was 95.8% in the first surgery.Conclusions: Inferior RD is a significant clinical and surgical challenge for vitreoretinal surgeons and the choice between the best surgical technique is still controversial. These cases frequently require some additional measures to vitreoretinal surgery due to its high recurrence rate. Our results show that vitrectomy with retinotomy alone on primary inferior RD has high anatomical and functional success rates.

Long-Term Outcomes of Same Patient Eyes Treated with Pars Plana Vitrectomy in One Eye and Conventional Treatment in the Other for Complications of Proliferative Diabetic Retinopathy.

The purpose of this study was to evaluate the long-term, real-world outcomes of pars plana vitrectomy (PPV) for complications of proliferative diabetic retinopathy. A retrospective review involving 64 patients with proliferative diabetic retinopathy that underwent PPV in their worse-seeing eye were followed for a minimum of 8 years. The fellow eye underwent conventional treatment. Patients were divided into two groups by age: patients younger than 50 years of age and patients older than 50. In the younger than 50 group, 89% of vitrectomized eyes had improved visual acuity (VA) while 3.6% had decreased VA. A total of 14% of vitrectomized eyes required additional laser and 11% required reoperations. In the conventional treatment eyes, 25% had improved VA while 68% had decreased VA (p < 0.05). A total of 72% required additional laser and 60% required PPV. In the older than 50 group, 86% of vitrectomized eyes had VA improvement and 3% had decreased VA. A total of 8% required laser and 8% required reoperations. In the conventional treatment eyes, 30% improved VA and 48% had decreased VA (p < 0.05). Additional procedures required included laser in 70% and PPV in 17%. In both age groups, eyes that underwent PPV had better final visual outcomes than eyes that received conventional treatment for PDR.