Session Title: Vitreoretinal Surgery III
Session Date/Time: Friday 12/09/2014 | 08:00-10:00
Paper Time: 09:20
Venue: Boulevard E
First Author: : S.Sheta EGYPT
Co Author(s): :
To evaluate the surgical outcome of vitrectomy for the management of diabetic vitreomacular traction with impending macular holes and the potential complications.
Twelve cases of diabetic vitreomacular traction with impending macular holes ( confirmed by OCT) were subjected to surgery.
23 gauge pars plana vitrectomy was done with high cutting rate and low suction. The posterior hyaloid was stained wit Triamcinolone Acetonide. The posterior hyaloid was circumcised around the focal point of attachment to the summit of the macular cyst without exerting traction on the posterior hyaloid. This will release traction on the macular cyst and the residual attachment of the vitreous to the apex of the cyst is removed using high suction and low cutting rate. The residual peripheral part of the posterior hyaloid is then safely removed. Macular grid laser photo coagulation is then used with minimum intensity.
All the macular cysts collapsed with regaining of nearly normal foveal architecture (as confirmed by OCT). No macular holes were created and visual improvement occurred in all cases.
Coventional surgical technique of detaching the posterior hyaloid in eyes with diabetic vitreomacular traction with impending macular holes carries the risk of deroofing the macular cysts and creating an iatrogenic macular hole. By this modified surgical technique we can release vitreomacular traction without inflicting iatrogenic damage to the thin, cystic and vulnerable macula. This will probably improve both anatomical and functional outcome.