THERAPEUTIC PARS-PLANA VITRECTOMY FOR CHRONIC UVEITIS - A RETROSPECTIVE STUDY OF THE LONG-TERM RESULTS

Background: Pars plana vitrectomy has both diagnostic and therapeutic potential in chronic uveitis. In this paper the therapeutic value of v itrectomy is investigated. Methods: This is a retrospective study on 2 5 eyes that underwent pars plana vitrectomy with therapeutic intent. S urgery was considered in patients with severe vitreous clouding or mac ular pucker and in those who responded poorly or not at all to convent ional treatment for uveitis. The mean period of follow up was 4.5 year s, varying from 2 to 12 years. Results: Improved vision was observed i n 56% of the eyes (14/25). Twenty-four percent of the eyes (6/25) had stable vision. Macular edema disappeared in 40% (10/25) of cases and p ersisted in 60% (15/25). Two of the nine eyes with persistent macular oedema progressed to a macular hole. Four of the six eyes with macular pucker suffered recurrence, one ended in phythisis, while the pucker was cured in only one patient. Twelve percent of the eyes (3/25) subse quently experienced a recrudescence of uveitis, making systemic treatm ent necessary. One patient presented, after vitrectomy, a traction ret inal detachment with proliferating vitreoretinopathy. No complications or recurrences were seen in 44% of the eyes (11/25). Conclusion: Vitr ectomy has a definite place in the treatment of chronic uveitis, both on the functional level, with improvement or stabilisation of visual a cuity and on the therapeutic level, with possible reduction or cessati on of systemic treatment.