Skip to main content
PMC home page
The British Journal of Ophthalmology logoLink to The British Journal of Ophthalmology
. 1994 Jul;78(7):549–554. doi: 10.1136/bjo.78.7.549

Long-term results of pars plana vitrectomy in the management of complicated uveitis.

A Heiligenhaus 1, N Bornfeld 1, M H Foerster 1, A Wessing 1
PMCID: PMC504862  PMID: 7918267

Abstract

This retrospective study evaluates the long term efficacy of pars plana vitrectomy on the preservation of vision in complicated chronic uveitis, including endogenous intermediate uveitis and other entities. Combined vitrectomy-lensectomy was performed in 10 eyes with complicated cataracts, and 18 vitrectomies were done without lensectomies. The mean follow up was 45 months. Additional retinal surgery (for example, scleral buckling) was performed in five eyes. Visual acuity improved in 23 eyes (82.8%) following surgery, with 16 eyes (57%) achieving a vision better than 6/24. The main causes for vision less than 6/24 were persistent cystoid macular oedema (three eyes), macular puckers (one eye), retinal vascular obliterations (four eyes), optic atrophy (five eyes), and chorioretinal scars (seven eyes). Postoperative complications were cataract formation (seven eyes), cystoid macular oedema (one eye), and tractional retinal detachments (three eyes). The surgical intervention resulted in a remarkable reduction of the severity of inflammation or frequency of exacerbations, and allowed significant tapering (11 eyes) or withdrawal (11 eyes) of the topical steroids, or oral corticosteroids (10 cases). Pre-existent cystoid macular oedema resolved in three eyes. Pars plana vitrectomy, eventually combined with lensectomy, may visually rehabilitate eyes with chronic uveitis and media opacities, and may reduce the activity of disease postoperatively.

Full text

PDF
553

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Algvere P., Alanko H., Dickhoff K., Lähde Y., Saari K. M. Pars plana vitrectomy in the management of intraocular inflammation. Acta Ophthalmol (Copenh) 1981 Oct;59(5):727–736. doi: 10.1111/j.1755-3768.1981.tb08739.x. [DOI] [PubMed] [Google Scholar]
  2. Belfort R., Jr, Nussenblatt R. B. Surgical approaches to uveitis. Int Ophthalmol Clin. 1990 Fall;30(4):314–317. doi: 10.1097/00004397-199030040-00023. [DOI] [PubMed] [Google Scholar]
  3. Belmont J. B., Michelson J. B. Vitrectomy in uveitis associated with ankylosing spondylitis. Am J Ophthalmol. 1982 Sep;94(3):300–304. doi: 10.1016/0002-9394(82)90354-3. [DOI] [PubMed] [Google Scholar]
  4. Binder S., Freyler H. Vitrektomie bei entzündlichen Erkrankungen des hinteren Augenabschnittes. Klin Monbl Augenheilkd. 1983 Aug;183(2):86–89. doi: 10.1055/s-2008-1054879. [DOI] [PubMed] [Google Scholar]
  5. Brinkman C. J., Otto A. J., Breebaart A. C. Ocular inflammatory activity following different techniques of lens extraction and vitrectomy in rabbits. Curr Eye Res. 1990 Dec;9(12):1137–1140. doi: 10.3109/02713689009003469. [DOI] [PubMed] [Google Scholar]
  6. Brinkman C. J., Otto A. J., Kijlstra A., Breebaart A. C. The influence of vitrectomy and lensectomy on experimental uveitis. Curr Eye Res. 1990;9 (Suppl):125–130. doi: 10.3109/02713689008999431. [DOI] [PubMed] [Google Scholar]
  7. Dangel M. E., Stark W. J., Michels R. G. Surgical management of cataract associated with chronic uveitis. Ophthalmic Surg. 1983 Feb;14(2):145–149. [PubMed] [Google Scholar]
  8. Devenyi R. G., Mieler W. F., Lambrou F. H., Will B. R., Aaberg T. M. Cryopexy of the vitreous base in the management of peripheral uveitis. Am J Ophthalmol. 1988 Aug 15;106(2):135–138. doi: 10.1016/0002-9394(88)90824-0. [DOI] [PubMed] [Google Scholar]
  9. Diamond J. G., Kaplan H. J. Lensectomy and vitrectomy for complicated cataract secondary to uveitis. Arch Ophthalmol. 1978 Oct;96(10):1798–1804. doi: 10.1001/archopht.1978.03910060310002. [DOI] [PubMed] [Google Scholar]
  10. Flynn H. W., Jr, Davis J. L., Culbertson W. W. Pars plana lensectomy and vitrectomy for complicated cataracts in juvenile rheumatoid arthritis. Ophthalmology. 1988 Aug;95(8):1114–1119. doi: 10.1016/s0161-6420(88)33051-4. [DOI] [PubMed] [Google Scholar]
  11. Foster C. S., Fong L. P., Singh G. Cataract surgery and intraocular lens implantation in patients with uveitis. Ophthalmology. 1989 Mar;96(3):281–288. doi: 10.1016/s0161-6420(89)32898-3. [DOI] [PubMed] [Google Scholar]
  12. Foster C. S. Vitrectomy in the management of uveitis. Ophthalmology. 1988 Aug;95(8):1011–1012. doi: 10.1016/s0161-6420(88)33062-9. [DOI] [PubMed] [Google Scholar]
  13. Freyler H., Velikay M. Vitrektomie bei Uveitis. Klin Monbl Augenheilkd. 1984 Oct;185(4):263–267. doi: 10.1055/s-2008-1054611. [DOI] [PubMed] [Google Scholar]
  14. Girard L. J., Rodriguez J., Mailman M. L., Romano T. J. Cataract and uveitis management by pars plana lensectomy and vitrectomy by ultrasonic fragmentation. Retina. 1985 Spring-Summer;5(2):107–114. doi: 10.1097/00006982-198500520-00009. [DOI] [PubMed] [Google Scholar]
  15. Klöti R. Pars-plana Vitrektomie bei chronischer Uveitis. Klin Monbl Augenheilkd. 1988 May;192(5):425–429. doi: 10.1055/s-2008-1050141. [DOI] [PubMed] [Google Scholar]
  16. Klöti R. Vitrektomie bei chronischer Uveitis und anderen entzündlichen Eintrübungen des Glaskörpers. Ber Zusammenkunft Dtsch Ophthalmol Ges. 1980;78:233–241. [PubMed] [Google Scholar]
  17. Leuenberger P. M. L'intérêt de la vitrectomie dans le traitement des uvéites postérieures. Klin Monbl Augenheilkd. 1984 May;184(5):445–448. doi: 10.1055/s-2008-1054518. [DOI] [PubMed] [Google Scholar]
  18. Lewis H., Aaberg T. M., Abrams G. W., Han D. P., Kreiger A. E. Management of the lens capsule during pars plana lensectomy. Am J Ophthalmol. 1987 Jan 15;103(1):109–110. doi: 10.1016/s0002-9394(14)74184-4. [DOI] [PubMed] [Google Scholar]
  19. Limon S., Renard J., Waligora G., Mokrane M. Intérêt de la vitrectomie dans les uvéites intermédiaires et la maladie de Behçet avec hyalite. Etude sur 400 cas. Ophtalmologie. 1989 Jun-Aug;3(3):206–208. [PubMed] [Google Scholar]
  20. Limon S., de Kyvon Y., Furia M., Bloch-Michel E. La vitrectomie au cours des uvéites. Indications et résultats. Bull Mem Soc Fr Ophtalmol. 1982;94:290–293. [PubMed] [Google Scholar]
  21. Margherio R. R., Trese M. T., Margherio A. R., Cartright K. Surgical management of vitreomacular traction syndromes. Ophthalmology. 1989 Sep;96(9):1437–1445. doi: 10.1016/s0161-6420(89)32711-4. [DOI] [PubMed] [Google Scholar]
  22. Michelson J. B., Friedlaender M. H., Nozik R. A. Lens implant surgery in pars planitis. Ophthalmology. 1990 Aug;97(8):1023–1026. doi: 10.1016/s0161-6420(90)32470-3. [DOI] [PubMed] [Google Scholar]
  23. Mieler W. F., Will B. R., Lewis H., Aaberg T. M. Vitrectomy in the management of peripheral uveitis. Ophthalmology. 1988 Jul;95(7):859–864. doi: 10.1016/s0161-6420(88)33095-2. [DOI] [PubMed] [Google Scholar]
  24. Nobe J. R., Kokoris N., Diddie K. R., Cherney E. F., Smith R. E. Lensectomy-vitrectomy in chronic uveitis. Retina. 1983;3(2):71–76. [PubMed] [Google Scholar]
  25. Nolthenius P. A., Deutman A. F. Surgical treatment of the complications of chronic uveitis. Ophthalmologica. 1983;186(1):11–16. doi: 10.1159/000309254. [DOI] [PubMed] [Google Scholar]
  26. Nussenblatt R. B. Macular alterations secondary to intraocular inflammatory disease. Ophthalmology. 1986 Jul;93(7):984–988. doi: 10.1016/s0161-6420(86)33654-6. [DOI] [PubMed] [Google Scholar]
  27. Pederson J. E., Kenyon K. R., Green W. R., Maumenee A. E. Pathology of pars planitis. Am J Ophthalmol. 1978 Dec;86(6):762–774. doi: 10.1016/0002-9394(78)90118-6. [DOI] [PubMed] [Google Scholar]
  28. Petrilli A. M., Belfort R., Jr, Abreu M. T., Lima A. L., Amaral M. G., Bonomo P. P. Ultrasonic fragmentation of cataract in uveitis. Retina. 1986 Winter-Spring;6(1):61–65. doi: 10.1097/00006982-198600610-00006. [DOI] [PubMed] [Google Scholar]
  29. Smith R. E., Kokoris N., Nobe J. R., Diddie K. R., Cherney E. F. Lensectomy-vitrectomy in chronic uveitis. Trans Am Ophthalmol Soc. 1983;81:261–275. [PMC free article] [PubMed] [Google Scholar]
  30. Ulbig M., Kampik A. Pars plana-Vitrektomie bei chronischer Uveitis des Kindes. Klin Monbl Augenheilkd. 1989 Jan;194(1):10–12. doi: 10.1055/s-2008-1046327. [DOI] [PubMed] [Google Scholar]
  31. Werry H., Honegger H. Pars-plana Vitrektomie bei chronischer Uveitis. Klin Monbl Augenheilkd. 1987 Jul;191(1):9–12. doi: 10.1055/s-2008-1050456. [DOI] [PubMed] [Google Scholar]

Articles from The British Journal of Ophthalmology are provided here courtesy of BMJ Publishing Group

RESOURCES