Vitrectomy with hyaloid separation shows efficacy for retinal vein occlusion-associated edema

INDIAN WELLS, Calif. — Performing vitrectomy with posterior hyaloid separation appears anatomically successful for treating patients with macular edema secondary to retinal vein occlusion, according to a study presented here at the American Society of Retina Specialists annual meeting.

The technique can be used for long-term anatomic improvement in these patients, said Michael M. Lai, MD, PhD. "However, visual acuity remained poor in most of our patients at the final follow-up visit due to the development of macular ischemia or macular scarring," he said.

Dr. Lai and colleagues retrospectively reviewed outcomes for 25 eyes with macular edema in 24 patients. Specifically, seven eyes had branch retinal vein occlusion, 16 eyes had central retinal vein occlusion and two eyes had hemi-retinal vein occlusion.

Patients averaged 70 years of age and had a mean preoperative visual acuity of 20/300. Follow-up averaged 27 months postoperatively, and all patients were followed for at least 12 months.

Postoperatively, 11 eyes (44%) were completely dry, and "the average duration of the dry macular exam was 18 months," Dr. Lai said.

"Postoperative fluorescein angiograms were available from 22 of the 25 eyes, and of those studied, 90% of the eyes were noted to be dry or showed decreased macular edema after surgery," he said.

Additionally, average macular thickness decreased from 487 µm to 281 µm postop.

Overall, macular edema worsened in two eyes (9%).

"While the anatomic outcomes for our patients were fairly excellent, we noted that the visual results were less than satisfying," Dr. Lai said.

At last follow-up, visual acuity averaged 20/200, and 28% of patients had lost vision, he said.