VITRECTOMY IN THE MANAGEMENT OF COMPLICAT ED UVEITIS

Background Vitrectomy serves as an important treatment modality in uve itis, removing inflamed vitreous body and eliminating secondary compli cations. The aim of our retrospective study was to evaluate the value of vitrectomy in the treatment of complications in uveitis. Patients a nd method We included 50 eyes of 50,patients suffering from chronic uv eitis, which underwent vitrectomy surgery during the period of 1990 to 1993. The study only included patients who had vitrectomy for uveitis for the first time. Indications leading to surgery were density of op tic media, retinal detachment, cyclitic or preretinal membranes. The m ean follow-up was 455 (range 48-1420) days. Results Vitrectomy was per formed ata mean delay of 452 days after initial presentation. The mean visual acuity at the time of surgery was 0,05. The best visual acuity postoperatively was measured at a mean time of 118 days after vitrect omy. Overall, at the last control, eyes with preoperative retinal deta chment presented a much worse final functional result (visual acuity o f 0,02) than eyes without detachment (visual acuity of 0,5). Ten eyes resulted in hypotonia after surgery (7 eyes with persisting hypotonia) . Most frequent complications in the postoperative course were macular pucker (11 eyes), secondary glaucoma (10 eyes), macular edema (6 eyes ) and retinal detachment (6 eyes). Fifty percent of all complications occurred within the first 3 months following surgery. Conclusion Vitre ctomy leads to a permanent increase in visual acuity through the treat ment of complications, on the condition that a stable retinal situatio n was present preoperativly.