25-gauge Vitrectomy for Complicated Chronic Endogenous/Autoimmune Uveitis: Predictors of Outcomes. (19th December 2012) - Soheilian, Masoud
Abstract: Purpose : To describe the course of inflammation and identify predictors of successful outcome in chronic endogenous/autoimmune uveitic patients following 25-gauge vitrectomy. Methods : In this retrospective study, charts of 74 patients (74 eyes) undergoing vitrectomy for complicated uveitis that had a minimum of 12 months follow-up were reviewed. Successful outcome measures were improvement (≥0.3 logMAR) of visual acuity (VA), decreased inflammatory activity (≥1+), and reduction of required drugs (more than one). Logistic regression techniques were used to identify predictors of successful outcomes. Result : A total of 44 (59%) of the 74 patients showed VA improvement, 38 (51%) showed decreased inflammatory activity, and 30 (40%) required fewer drugs following vitrectomy. Independent predictor for VA improvements was accompanying cataract extraction, for postoperative inflammatory decrease was the absence of preoperative cystoid macular edema and greater preoperative activity of inflammation, and for the reduction in the number of required drugs was preoperative presence of epiretinal membrane formation. Conclusion : 25-gauge vitrectomy may be beneficial in patients with complicated chronic endogenous uveitis in terms of VA and control of inflammation. Accompanying cataract extraction, when necessitated, during vitrectomy and the absence of preoperative cystoid macular edema were indicators of better outcomes. Establishing predictors may assist clinicians in better patient selection.