title: Lamina puncture for central retinal vein occlusion: results of a pilot trial.
abstract: OBJECTIVE
  To evaluate the effect of treatment by lamina puncture, a novel procedure to create a perivascular opening within the optic nerve head by a transvitreal approach, on visual acuity after central retinal vein occlusion (CRVO) in older patients.
  
  
  METHODS
  The patients comprised a nonrandomized, consecutive, interventional case series of older patients being seen with CRVO. Patients 65 years or older with CRVO and a visual acuity of 20/200 or worse were treated with vitrectomy and lamina puncture of the optic disc. Preoperative visual acuity, clinical examination results, and fluorescein angiography results were compared with postoperative results.
  
  
  RESULTS
  Twenty patients (12 men and 8 women), an average age of 72 years, were enrolled. The mean duration of CRVO was 5.4 months; 14 eyes had nonischemic CRVO when first seen, while 6 had substantial ischemia. The mean preoperative visual acuity was in the counting fingers range, and the mean postoperative visual acuity was also in the counting fingers range. Complications included 5 eyes with iris neovascularization, of which 4 progressed to neovascular glaucoma; also, preoperative ischemia seemed to predispose to neovascular complications.
  
  
  CONCLUSIONS
  Lamina puncture does not restore visual acuity in older patients with CRVO.
authors.affiliation: Retina Service, Massachusetts Eye and Ear Infirmary, Harvard Medical School, 243 Charles Street, Boston, MA 02114, USA. djdamico@meei.harvard.edu
authors.forename: Donald J
authors.initials: DJ
authors.lastname: D'Amico
authors.forename: Eugene S
authors.initials: ES
authors.lastname: Lit
authors.forename: Francesco
authors.initials: F
authors.lastname: Viola
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001485:Basement Membrane / Q000601:surgery; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D008297:Male; D008875:Middle Aged; D009898:Optic Disk / Q000601:surgery*; D010865:Pilot Projects; D011183:Postoperative Complications; D011677:Punctures / Q000379:methods*; D012170:Retinal Vein Occlusion / Q000503:physiopathology / Q000601:surgery*; D014792:Visual Acuity / Q000502:physiology; D014821:Vitrectomy