Pars Plana Vitrectomy for the Treatment of Uveitis

Henry, Christopher R.; Becker, Matthias; Yang, Yongsheng; Davis, Janet L.

doi:10.1016/j.ajo.2018.03.031

Cited by 31 publications

(20 citation statements)

References 41 publications

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“…5 These results were similar to our findings of cases with a combined PCIOL/PPV (62% vs 62.4% at 9 months and final follow-up, respectively) and those with vitrectomy only. 5,12 Overall, nearly 85% of the patients in our study had an improvement in BCVA at their last follow-up compared with preoperative BCVA despite ocular comorbidities. Thus, a combined approach resulted in favorable outcomes despite the longer, more complicated surgery while also increasing the chance of disease remission.…”

Section: Discussionmentioning

confidence: 72%

“…[6][7][8] In several other studies, there has been a reported reduction in the incidence of CME and disease activity in patients with intermediate uveitis who have undergone a pars plana vitrectomy (PPV) only. [9][10][11][12] A combined phacoemulsification with PPV has shown efficacy in rapid visual rehabilitation in patients with early or visually significant cataracts and concurrent vitreoretinal pathology and has shown promise in uveitic eyes, while improving visualization during retinal surgery. [13][14][15] Although unproven, it has been hypothesized that removal of proinflammatory cytokines and autologous foreign material via vitrectomy may alter the immunologic milieu within the posterior segment.…”

Section: Introductionmentioning

confidence: 99%

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Combined Phacoemulsification and Pars Plana Vitrectomy for the Treatment of Cataract in Patients With Noninfectious Uveitis

Conrady

Shakoor

Patel

et al. 2020

Journal of VitreoRetinal Diseases

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Purpose: This work evaluates the role of combined phacoemulsification and vitrectomy surgery in the management of cataract associated with noninfectious uveitis. Methods: A retrospective chart review was conducted of all patients aged 7 years or older who underwent a combined surgical approach from 2005 to 2018. Results: Eighty-five eyes of 67 patients were included in the study; 10.7% of eyes had a best-corrected visual acuity (BCVA) of 20/40 or better at time of surgery. At 1-year follow-up, 63.4% of eyes had a BCVA 20/40 or better and 7.6% had a BCVA of 20/200 or worse. There was an overall decrease in cystoid macular edema after surgery compared with preoperatively (47.6% vs 34.5% presurgery and postsurgery, respectively). Complete inflammatory disease remission off immunomodulatory therapy and systemic steroids was achieved in 21.1% of patients. Conclusions: A combined surgical approach is effective in visual rehabilitation in patients with uveitic cataracts and may promote inflammatory disease remission specifically in intermediate uveitis.

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Section: Discussionmentioning

confidence: 72%

Section: Introductionmentioning

confidence: 99%

Combined Phacoemulsification and Pars Plana Vitrectomy for the Treatment of Cataract in Patients With Noninfectious Uveitis

Conrady

Shakoor

Patel

et al. 2020

Journal of VitreoRetinal Diseases

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“…Various studies have reported to have a beneficial effect of pars plana vitrectomy on the course of uveitis and associated CME. [19] However the role of vitrectomy in the management of CME following infectious uveitis remains largely unexplored and proper studies are needed to define the role and indications of vitrectomy in these patients.…”

Section: Discussionmentioning

confidence: 99%

Intravitreal sustained-release dexamethasone implant for the treatment of persistent cystoid macular edema in ocular syphilis

Majumder¹,

Mayilvakanam

Palker

et al. 2019

Indian J Ophthalmol

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With a resurgence of syphilis with human immunodeficiency virus (HIV) infection in last few years, various ocular manifestations of syphilis have been described in literature. This case report described an HIV-positive patient on anti-retroviral therapy who was diagnosed and treated for posterior uveitis secondary to ocular syphilis in the recent past presented to our clinic with cystoid macular edema (CME). CME, which did not respond to periocular corticosteroid, resolved with intravitreal sustained release dexamethasone implant. There was a recurrence CME 9 months later and repeat injection of intravitreal implant showed complete resolution. A long-term follow-up did not reveal reactivation of the infection with intravitreal corticosteroid. Intravitreal sustained release dexamethasone implant can be an effective treatment for refractory CME in patients with regressed syphilitic uveitis.

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“…Six series emphasized vitrectomy as a specific treatment for intermediate uveitis [210][211][212][213][214][215]. For series published after 2005, the median time on medical treatment until vitrectomy was 36 months [209]. Long-term followup of a small series of pediatric patients with intermediate uveitis indicated beneficial results from pars plana vitrectomy (PPV) [216] similar to other series involving children [215,217,218].…”

Section: Vitrectomymentioning

confidence: 95%

“…Vitrectomy in the treatment of uveitis has been reviewed [208,209]. Prior to 2006, patients with intermediate uveitis accounted for half of the 1762 eyes reported in 44 interventional case series.…”

Section: Vitrectomymentioning

confidence: 99%