Pars plana vitrectomy for resistant cystoid macular edema

Abstract

Objective: To evaluate the results of pars plana vitrectomy for cystoid macular edema (CME) resistant to medical treatment. Study Design: Quasi-experimental study Place and Duration of Study: Al-Shifa Trust Eye Hospital, Rawalpindi, from January to July 2019. Methodology: This study recruited 30 eyes of 30 patients with cystoid macular edema confirmed on optical coherence tomography that was refractory to medical treatment. Eyes with diabetic fibrous proliferation, optic atrophy, neo-vascular glaucoma, membrance and macular retinal pigment epithelial atrophy were excluded from the study. All patients underwent 23 G pars plana vitrectomy followed by epiretinal membrane / internal limiting membrane (ERM/ILM) peeling and gas injection. In 11 eyes, perfluoropropane gas was injected; while in 19 eyes, sulfurhexafluoride gas was injected. Main outcome measures included pre- and post-op Snellen's visual acuity and central macular thickness (CMT). All patients completed their follow-up of six months. Results: Mean age of 16 male and 14 female patients was 54.30 ±3.70 years. Postoperative Snellen's visual acuity improved to 0.61 ±0.08 from 0.11 ±0.04 and postoperative central macular thickness improved to 223.80 ±40.20 µm from 578.00 ±26.57 µm. Both differences were statistically significant (p<0.001). Conclusion: Pars plana vitrectomy with ERM / ILM peel and gas injection for CME refractory to medical treatment is an effective treatment. There was significantly improved best corrected visual acuity (BCVA) postoperatively along with decreased CMT on optical coherance tomography (OCT).