Session Title: Vitreoretinal Surgery II
Session Date/Time: Thursday 26/09/2013 | 14:30-16:00
Paper Time: 14:30
Venue: Hall 3 (Level 0)
First Author: M.Uparkar INDIA
To analyze the visual outcomes of vitreomacular traction after vitrectomy and correlate this with the pre-operative morphology.
Retrospective study in patients with vitreomacular traction and visual symptoms operated at a single tertiary eye care center in Mumbai city
Patients with Vitreomacular traction (VMT) due to diabetic macular edema or central retinal vein occlusion and operated between 2012 and 2013 were identified .Routine pre-operative assessment for BCVA ( Snellen) , Goldmann applanation tension , refraction and dilated fundus evaluation was followed by assessment of VMT by OCT ( SD OCT 2000). ( Microincision vitrectomy surgery (MIVS) was done by single surgeon using standard 23G instruments (Alcon) .Post-operative visual acuity and VMT assessment using OCT was done at 4 weeks and 16 weeks after surgery.
Two types of VMT were noted . Those with broad attachment along the retinal surface and at fovea and those with focal tenting of the fovea with localized or point attachment . 23 eyes of 23 patients were studied . Median age at diagnosis was 56 years with 72 percent being male. Diabetic maculopathy was the most common etiology in 64%( 15/23) eyes. Median duration of symptoms was 4 months. Median pre-operative BCVA was 6/18 with focal VMT in 11Eyes and broad VMT ( Tangential ) in 12 Eyes. The final BCVA at 16 weeks was significantly better than the presenting BCVA ( p<0.05) . In eyes with DME and VMT the visual acuity showed significantly better outcome after surgery mean change of 3 lines on Snellen Morphological restoration of retinal and foveal architecture was seen in 19 eyes . Eyes with non-diabetic VMT showed morphological resolution however the post surgical BCVA was not statistically significantly better than pre-op BCVA(p<0.05). DME patients were more more likely to have focal VMT (OR 3.1 95%CI 2.2-5.7)
In this series , DME patients were more likely to have a focal vitreomacular traction complex which shows significant VA improvements after vitrectomy . Broad vitreomacular traction was seen more often in central vein occlusion and showed anatomical resolution without significant visual improvement post vitrectomy.