Vitrectomy with complete posterior hyaloid removal for ischemic central retinal vein occlusion: series of cases.
BACKGROUND
Central retinal vein occlusion (CRVO) is a common retinal vascular disorder with potentially complications: (1) persistent macular edema and (2) neovascular glaucoma. No safe treatment exists that promotes the return of lost vision. Eyes with CRVO may be predisposed to vitreous degeneration. It has been suggested that if the vitreous remains attached to the macula owing to a firm vitreomacular adhesion, the resultant vitreous traction can cause inflammation with retinal capillary dilation, leakage and subsequent edema6. The roll of vitrectomy in ischemic CRVO surgical procedures has not been evaluated.


METHODS
This is a non comparative, prospective, longitudinal, experimental and descriptive series of cases. Ten eyes with ischemic CRVO. Vitrectomy with complete posterior hyaloid removal was performed. VA, rubeosis, intraocular pressure (IOP), and macular edema were evaluated clinically. Multifocal ERG (m-ERG), fluorescein angiography (FAG) and optic coherence tomography (OCT) were performed. Follow-up was at least 6 months. Moderate improvement of visual acuity was observed in 60% eyes and stabilized in 40%. IOP changed from 15.7 +/- 3.05 mmHg to 14.9 +/- 2.69 mmHg post-operative and macular edema from 976 +/- 196 microm to 640 +/- 191 microm to six month. The P1 wave amplitude changed from 25.46 +/- 12.4 mV to 20.54 +/- 11.2 mV.


CONCLUSIONS
A solo PPV with posterior hyaloid removal may help to improve anatomic and functional retina conditions in some cases. These results should be considered when analyzing other surgical maneuvers.
Leizaola-Fernández
Carlos
C
Department of Retina, Hospital Dr. Luis Sánchez Bulnes Asociación Para Evitar la Ceguera en México, Distrito Federal, Mexico. CarlosLeizaola@hotmail.com
Suárez-Tatá
Luis
L
Quiroz-Mercado
Hugo
H
Colina-Luquez
Juner
J
Fromow-Guerra
J
J
Jiménez-Sierra
Juan M
JM
Guerrero-Naranjo
Jose L
JL
Morales-Cantón
Virgilio
V
D000368:Aged; D001485:Basement Membrane / Q000601:surgery; D004596:Electroretinography; D005260:Female; D005451:Fluorescein Angiography; D005500:Follow-Up Studies; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D007511:Ischemia / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012170:Retinal Vein Occlusion / Q000503:physiopathology / Q000601:surgery*; D012171:Retinal Vessels; D041623:Tomography, Optical Coherence; D014792:Visual Acuity / Q000502:physiology; D014821:Vitrectomy; D014822:Vitreous Body / Q000601:surgery*