Intentional complete interruption of a retinal vein after vitrectomy might improve the rate of successful chorioretinal venous anastomosis formation in central retinal vein occlusion.
BACKGROUND
Laser or surgical chorioretinal venous anastomosis has not become widespread as suitable treatment for central retinal vein occlusion (CRVO). We report here the effectiveness of cutting off a retinal vein with vitrectomy in making a chorioretinal venous anastomosis in CRVO.


METHODS
We performed a vitrectomy accompanied by a chorioretinal venous anastomosis procedure for seven consecutive patients with CRVO. These patients had shown no improvement in their visual acuity in the month following their first visit to our hospital and had a visual acuity of less than 20/200. Their preoperative visual acuity ranged from counting fingers to 20/300. The procedure included the complete cutting of the affected retinal vein, and the making of a small incision at both sides of the vein interruption through the full thickness of the retina, the retinal pigment epithelium and Bruch's membrane.


RESULTS
In five of the seven patients, successful chorioretinal venous anastomosis was observed. All five patients showed an improvement of two or more lines in visual acuity 6 months postoperatively. In three of the five, visual acuity was 20/100 or better. A postoperative complication of recurrent vitreous hemorrhage and fibrous proliferation was observed in one patient, and a second operation was necessary.


CONCLUSIONS
Surgical interruption of an affected vein was a feasible procedure and could raise the rate of successful chorioretinal venous anastomosis in CRVO.
Koizumi
Kan
K
Department of Ophthalmology, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-hirokoji, Kamigyo-ku, Kyoto 602-0141 Japan. kkoizumi@ophth.kpu-m.ac.jp
Nishiura
Masatoshi
M
Yamamoto
Takami
T
Machida
Teruyo
T
Nakamura
Tomiko
T
Ouchi
Masayuki
M
Kinoshita
Shigeru
S
D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical; D002829:Choroid / Q000098:blood supply*; D005260:Female; D005654:Fundus Oculi; D006801:Humans; D008297:Male; D012169:Retinal Vein / Q000601:surgery*; D012170:Retinal Vein Occlusion / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D014680:Veins / Q000601:surgery; D014792:Visual Acuity; D014821:Vitrectomy