title: ELECTRONIC MEDICAL RECORD DATABASE STUDY OF VITRECTOMY AND OBSERVATION FOR VITREOMACULAR TRACTION.
abstract: OBJECTIVE
  To audit the natural history of vitreomacular traction, and the risks and benefits of surgery.
  
  
  METHODS
  Database study of 1,254 patients (1,399 eyes) with vitreomacular traction from 16 UK vitreoretinal units.
  
  
  RESULTS
  The median age was 75 years, with 36.2% of patients diagnosed as diabetic. In 986 (70.5%) eyes managed conservatively, the median presenting logarithm of the minimum angle of resolution visual acuity of 0.30 (Snellen 20/40) was unchanged over follow-up. Of 413 eyes (29.5%) that required pars plana vitrectomy, the median preoperative visual acuity improved from 0.60 to 0.50 (20/80-20/63), 6 months to 12 months after surgery, with 33% gaining at least 0.3 units (approximately 2 Snellen lines). Vitrectomy was combined with internal limiting membrane peel in 43.8%, epiretinal membrane peel in 42.4%, gas/air tamponade in 46.2%, and cataract surgery in 27.9%. One or more intraoperative complications occurred in 12.6%; most commonly retinal breaks (8.0%), retinal trauma (1.9%), and retinal hemorrhage (1.0%). Postoperative retinal detachment occurred in 2.7% and macular hole in 2.2%. The 1, 2, and 3 year rates of postvitrectomy cataract surgery were 28.2%, 38.2%, and 42.7%, respectively.
  
  
  CONCLUSIONS
  Many eyes with vitreomacular traction have stable visual acuity. Those progressing to vitrectomy have relatively modest visual acuity gains, and complications are not infrequent.
authors.affiliation: *Department of Ophthalmology, King's College London, London, United Kingdom; and †Department of Ophthalmology, Gloucestershire Hospitals NHS Foundation Trust, Gloucester, United Kingdom.
authors.forename: Timothy L
authors.initials: TL
authors.lastname: Jackson
authors.forename: Paul H J
authors.initials: PH
authors.lastname: Donachie
authors.forename: Robert L
authors.initials: RL
authors.lastname: Johnston
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D016208:Databases, Factual; D057286:Electronic Health Records / Q000706:statistics & numerical data*; D019773:Epiretinal Membrane / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D019370:Observation; D012164:Retinal Diseases / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D012189:Retrospective Studies; D000267:Tissue Adhesions / Q000175:diagnosis; D014792:Visual Acuity / Q000502:physiology; D014821:Vitrectomy / Q000706:statistics & numerical data*; D020255:Vitreous Detachment / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*