Pars-plana Vitrektomie bei chronischer Uveitis

Abstract

Statistical analysis of 54 eyes with chronical endogenous uveitis, mostly juvenile, treated with simple or combined pars plana vitrectomy. Most striking is the high frequency of localized or combined cyclitis with good functional results, although complications of the disease (retinal detachment, vasculitis, PVR, macular damage) are extremely frequent in cyclitis, and this group also includes, three cases of postoperative phthisis. The best argument in favor of an chronic uveitis is the fact that an overwhelming majority of the patients were able to switch from rigorous systemic preoperative medication to simple eye drops or no treatment at all.

Vitrectomy for juvenile uveitis: prognostic factors for the long-term functional outcome

“…This complication has first been described by Klö ti. 15 In 2 eyes, RD with PVR (preexisting in one of them) required reoperations.…”

“…There is evidence from numerous studies that PPV can lead to an improvement in visual acuity and reduce CME, and uveitic exacerbations. [3][4][5][6][7][8][9][10][11][12][13][14][15][16] There are only three reports focusing on therapeutic PPV in a paediatric population (in total 43 eyes) with chronic uveitis. [17][18][19] All three groups reported a postoperative improvement in visual acuity, a CME reduction, and reduced rate of recurrences with a subsequently achieved reduction of the immunomodulatory therapy after follow-up times of 6 months to 10 years.…”

Vitreous surgery in the management of chronic endogenous posterior uveitis

“…[9][10][11][12][13] In our study, the number and classes of medications did not change in the postoperative period. This difference may be explained by the increased use of immunosuppression in the immediate postoperative period.…”

“…6,8,9 Clinical assessment of CMO in a retrospective series is subject to the inaccuracies of the objectivity of the examination and the difficulties of fundal viewing through vitreous debris. Nevertheless, the authors believe that the findings of this study represent a true therapeutic effect of PPV and deserve further investigation.…”

“…There is a reported improvement in visual acuity, 6,7 with a reduction in the incidence of cystoid macular oedema. 8,9 The number of uveitic exacerbations is also reduced with fewer immunosuppressive medications required. [10][11][12][13] PPV in uveitis can also be a useful aid in diagnosis by providing a view of the fundus and biopsy material for laboratory analysis.…”