[Vitreous surgery for proliferative maculopathy].

OBJECTIVE

To explore the indication of vitrectomy for the treatment of pre-macular proliferative disease, the surgical technique, results and the prevention and treatment of complications.

METHODS

Forty-one eyes of 41 cases with different kinds of macular traction or macular pucker, including 12 cases of idiopathic epimacular membrane, 10 cases of macular hole complicated with epimacular membrane and 19 cases of macular pucker after reattachment surgery (no diabetic retinopathy or retinal detachment) were treated with vitreous surgery. The issue of this operation is to find out underlying fissures (an under-bridge) or weakly adherent sites between a membrane and the retina. Using flute-needle, intraocular pick, spade and vitreoretinal forceps, we can separate and peel the proliferative membrane and the posterior cortical vitreous from the retinal surface completely.

RESULTS

In 41 cases, epimacular membrane was peeled successfully, and the normal anatomic structure of the macula was restored. Four cases had small amount of hemorrhage in the superficial layer of the retina in and after the operation, and all the other cases did not have any complications, such as retinal tear or detachment. Thirty-eight cases obtained higher visual acuity, and in 3 cases the visual acuity maintained at their pre-operative level. Metamorphopsia was significantly improved, even disappeared. The follow-up period was 3 months to 4 years.

CONCLUSIONS

The therapeutic effects of vitreous surgery for treatment of various kinds of proliferative maculopathy are reliable. After the surgery, the visual acuity can be elevated, the symptoms can be ameliorated and the complications can be effectively controlled.