Surgical Results in Ocriplasmin Candidates With Symptomatic Vitreomacular Traction Syndrome. (1st February 2018)

• Record Type: Journal Article
• Authors: Vasquez, Dario H.; Altamirano, Juan C.; Casaus, Angel; Del Valle, Rodrigo A.; Gonzalez, Roberto; Gonzalez-De La Rosa, Alejandro; Navarro-Partida, Jose; Vasquez, Martin A.; Santos, Arturo
• Is Part Of: Current eye research. Volume 43:Number 2(2018)
• Page Start: 208
• Page End: 212
• Publication Date: 2018-02-01
• Subjects: Retina -- vitreomacular traction -- ocriplasmin -- metamorphopsia -- macular hole; Ophthalmology -- Periodicals; Eye -- Diseases -- Periodicals; Ophthalmology -- Periodicals; 573.88
• DOI: 10.1080/02713683.2017.1385086
• Languages: English
• ISSNs: 0271-3683

Abstract

ABSTRACT: Purpose : To report surgical outcomes in a series of cases with symptomatic vitreomacular traction that met MIVI-TRUST (Microplasmin for intravitreous injection-traction release without surgical treatment) criteria for ocriplasmin use who underwent primary 25-gauge vitrectomy. Materials and Methods : A single-center retrospective chart review study was performed in patients who underwent primary 25-gauge vitrectomy for symptomatic vitreomacular traction (VTM) from January 2013 through January 2016. Pre- and postoperative visual acuity (measured by the early treatment diabetic retinopathy acuity test), and posterior hyaloid focal attachment to the macula (demonstrated by high-definition optical coherence tomography) were analyzed. In addition, intra- and postoperative complications were obtained from medical records. Results : Fifteen consecutive cases of symptomatic VMT traction that underwent primary 25-gauge vitrectomy were included. All met the MIVI-TRUST criteria for ocriplasmin use. In all cases, VMT resolution, macular hole closure, and improvement in best corrected visual acuity (BCVA) were observed. Mean visual acuity improved from 56.53 ± 16.04 letters at baseline to 73.13 ± 7.46 letters at 24 weeks of follow-up. The mean BCVA improvement from baseline was 16.60 letters (range 6–44), which was statistically significant ( P < 0.0001). Ten of fifteen patients (66.6%) showed significant improvement of their BCVA to 20/40 or better (70 or more in ETDRS visual acuity test). No significant intra- or postoperative complications were documented. Conclusions : Primary 25-gauge pars plana vitrectomy in eyes with symptomatic vitreomacular traction is able to efficiently resolve VMT and macular holes, improving vision in candidates for intravitreal injection of ocriplasmin. This well-tolerated surgical procedure may be a reliable and predictable alternative for resolving VMT pathology.