Vitrectomy for traction macular edema

Purpose: Traction macular edema may develop through contraction of macular epiretinal membranes (ERM), or due to persistant vitreomacular traction dur ing the evolution of vitreomacular traction syndrome (VMS). The purpose of this retrospective study was to determine the effect of vitreous surgery an d the release of the vitreomacular traction or the removal of epiretinal me mbranes, on the evolution of traction induced macular edema. Material and m ethods: Fourteen eyes from 14 patients presenting with idiopathic or second ary epiretinal membranes, and 11 eyes from 10 patients presenting with vitr eomacular traction syndrome, underwent vitrectomy for reduced vision and cy stoid macular edema, identified by slit-lamp examination and fluorescein an giography. No coexistent ocular conditions that might have caused macular t raction were present. History, preoperative eye examination, operative find ings, postoperative course and final examination as well as pre- and postop erative fluorescein angiography were reviewed. Results: In the ERM group, c ystoid macular edema disappeared in all cases during the postoperative peri od and the mean visual acuity (VA) at the end of the follow-up (0.48 +/- 0. 23) significantly increased compared to the preoperative one (0.29 +/- 0.2) (p=0.004). In the group of patients suffering from VMS, the posterior vitr eous traction on the macula was released and macular edema disappeared in a ll cases but one. The mean v.a. at the end of the follow-up (0.42 +/- 0.24) significantly increased compared to the preoperative one (0.18 +/- 0.1) (p =0.01). Complications included intraoperative small petechias and postopera tive progressive nuclear sclerosis, retinal detachment and retinal pigment epitheliopathy. Conclusions: Cystoid macular edema may develop secondary to vitreomacular traction syndrome or epiretinal membrane contraction. Vitrec tomy is effective in releasing macular traction which, in turn, may induce a decrease of the macular edema with improvement of visual acuity.