Vitrectomy safe, helpful for controlling uveitis
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FORT LAUDERDALE, Fla. — Pars plana vitrectomy can be useful for controlling uveitis, according to a speaker here.
“Based on what we have in the literature, pars plana vitrectomy appears to be safe and helpful in controlling inflammation, controlling and reducing [cystoid macular edema], improving visual acuity and reducing the number of medications locally and systemically in order to have good control over uveitis,” Virgilio Morales-Canton, MD, said at the Retina World Congress. “What we have to remember is that it is not necessary to perform vitrectomy in all cases.”
Vitrectomy has evolved over the past 50 years, Morales-Canton said, with modern 23-, 25- and 27-gauge technology, wide-angle viewing systems and upgraded machine fluidics contributing to improved safety.
Diagnostic vitrectomy should be considered when other noninvasive methods have failed, he said. Patients should also be considered for vitrectomy if they have an atypical presentation, suspected intraocular malignancy or infection, chronic uveitis of unknown etiology or a systemic workup that is inconclusive.
An important preoperative consideration for vitrectomy in patients with uveitis is addressing inflammation 2 to 3 months before surgery using a steroid, Morales-Canton said.
“This is especially true if we are going to do, additionally, a cataract surgery or implantation of an IOL,” he said.
Pars plana vitrectomy is the preferred inflammatory control method for phacogenic uveitis, Morales-Canton said, although the therapeutic role of vitrectomy for managing noninfectious intermediate, posterior or panuveitis is less well defined.
Some reports have found prophylactic vitrectomy useful for acute retinal necrosis.
“The definitive role of this technique is not clear yet,” Morales-Canton said.
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Morales-Canton V. Vitrectomy in uveitis. Presented at: Retina World Congress; May 12-15, 2022; Fort Lauderdale, Fla.
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