Vitrectomy in uveitis patients.

B Pion, Z S Valyi, X Janssens, P Koch, J Libert, L Caspers, F Willermain
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Abstract

Purpose: To evaluate the causes and success rates of pars plana vitrectomy (PPV) in uveitis patients.

Methods: Retrospective study of the charts of 26 uveitis patients (28 eyes) who underwent PPV between the years 2008 and 2011. We examined surgical indications and success rates, based on visual outcomes, complications and diagnosis in case of vitreous biopsy.

Results: (1) Therapeutic PPV (TV) was performed in 36% of the eyes, (2) TV combined with epiretinal membrane (ERM) peeling in 21% and (3) diagnostic PPV (DiV) was performed in 64% of the eyes. Eight eyes (28,6%) underwent a combined cataract and vitreous surgery. Visual acuity (VA) improved in 16 eyes (57%), with a mean improvement of -0,9 log of the minimum angle of resolution (logMAR), although the effect was transient in 7% of the cases. VA remained stable in 11 eyes (39%) and decreased in 1 (4%). Post-operative complications were cystic macular oedema (CMO) in 3 eyes (11%), cataract in 5 eyes (18%) and retinal detachment in 2 eyes (7%). Diagnostic tests were performed in 18 eyes with a success rate of 55%.

Conclusions: In our series of patients with uveitis, a good andstable improvement of VA was found when PPV was performed with ERM peeling while the effect on VA was more transient in the other cases. A good success rate of diagnosis was also found in DiV. However, considering the possible severe complications, diagnostic vitrectomy should be limited to selected cases.

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葡萄膜炎患者的玻璃体切除术。
目的:探讨葡萄膜炎患者行睫状体部玻璃体切除术的原因及成功率。方法:回顾性分析2008 ~ 2011年间26例(28眼)行PPV手术的葡萄膜炎患者的病历。我们根据视力结果、并发症和玻璃体活检的诊断检查了手术指征和成功率。结果:(1)治疗性PPV (TV)占36%,(2)TV合并视网膜前膜(ERM)剥离占21%,(3)诊断性PPV (DiV)占64%。8只眼(28.6%)接受了白内障和玻璃体联合手术。16只眼(57%)的视力(VA)得到改善,最小分辨角(logMAR)的平均改善为-0,9 log,尽管7%的病例的效果是短暂的。11只眼(39%)VA保持稳定,1只眼(4%)VA下降。术后并发症为囊性黄斑水肿(CMO) 3眼(11%),白内障5眼(18%),视网膜脱离2眼(7%)。在18只眼睛中进行了诊断测试,成功率为55%。结论:在我们的一系列葡萄膜炎患者中,当PPV与ERM剥离时,VA得到了良好而稳定的改善,而在其他病例中,VA的效果更为短暂。DiV的诊断成功率也很高,但考虑到可能出现的严重并发症,诊断性玻璃体切除术应限于选定病例。
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