Surgical chorioretinal venous anastomosis for ischemic central retinal vein occlusion

BACKGROUND AND PURPOSE: To report results of a pilot study to create chorio retinal venous anastomosis (CRVA) in eyes with ischemic central retinal vei n occlusion (CRVO) via a pars plana approach. PATIENTS AND METHODS: Five eyes of 5 patients with ischemic CRVO underwent surgical CRVA. Following pars plana vitrectomy, the posterior hyaloid face was removed, and slit-like incisions were made with a microvitreoretinal bl ade adjacent to a major retinal vein in each quadrant. Small pieces of 5-0 Mersilene sutures (Ethicon, Somerville, NJ) were positioned over the vein a nd inserted into these incisions to promote vascularization. Panretinal pho tocoagulation was applied. RESULTS: A functional CRVA site was noted at 10 of 16 attempted sites (4 si tes in 1 patient could not be evaluated because of cataract). Minor fibrous proliferation was noted at CRVA sites in all eyes. Optic atrophy developed in 3 eyes. Visual acuity improved in 3 eyes, remained unchanged in 1, and deteriorated in 1 eye after a mean follow up of 13.4 months (range 8-20 mon ths). CONCLUSION: Surgically induced CRVA may improve the prognosis in some eyes with ischemic CRVO.