Pars plana vitrectomy for chronic pseudophakic cystoid macular edema.
OBJECTIVE
We determined the efficacy of pars plana vitrectomy in a series of patients with chronic pseudophakic cystoid macular edema.


METHODS
Clinical records were reviewed on 24 consecutive patients who underwent pars plana vitrectomy in one eye for chronic pseudophakic cystoid macular edema. All 24 patients had failed to improve on medical therapy and had preoperative evidence of either vitreous adhesions to anterior segment structures (23 eyes) or iris capture of the intraocular lens (one eye).


RESULTS
The mean, best-corrected Snellen visual acuity was 20/190 preoperatively (median, 20/200; range, 20/50 to 3/200) and 20/52 postoperatively (median, 20/40; range, 20/20 to 20/400 [P < .0001]). Visual acuity improved postoperatively in all 24 eyes, with a mean improvement of 4.7 Snellen lines (range, one to eight lines). There was no highly significant difference in preoperative visual acuity (P = .41) or postoperative visual improvement (P = .17) between patients with anterior as opposed to posterior chamber intraocular lenses. Longer time interval from cataract surgery to vitrectomy did not correlate with less postoperative visual improvement.


CONCLUSIONS
In pseudophakic eyes with chronic cystoid macular edema, vitreous adhesions to anterior segment structures, and visual loss that is unresponsive to medical therapy, pars plana vitrectomy with removal of these vitreous adhesions may lead to improved visual acuity.
Harbour
J W
JW
Department of Ophthalmology, University of Miami School of Medicine, Bascom Palmer Eye Institute, Florida, USA.
Smiddy
W E
WE
Rubsamen
P E
PE
Murray
T G
TG
Davis
J L
JL
Flynn
H W
HW
D000368:Aged; D000369:Aged, 80 and over; D000869:Anterior Eye Segment / Q000473:pathology; D002387:Cataract Extraction; D002908:Chronic Disease; D005128:Eye Diseases / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D007499:Iris Diseases / Q000473:pathology / Q000601:surgery; D007910:Lenses, Intraocular; D008269:Macular Edema / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D000267:Tissue Adhesions / Q000601:surgery; D014792:Visual Acuity; D014821:Vitrectomy; D014822:Vitreous Body / Q000473:pathology