gms | German Medical Science

Purpose: To characterize development of best corrected visual acuity (BCVA) after 23 g vitrectomy in patients with macular pucker.

Design: Retrospective study.

Methods: 56 eyes of 56 consecutive patients who underwent surgery for macular pucker were identified. All eyes were performed in local anesthesia with use of one step 23 g vitrectomy and use of brilliant blue. No ICG was used, all eyes were tamponated with air after peeling of epiretinal membranes and the ILM. Eyes were split into 2 groups: those with a preoperative BCVA under or equal to 20/200 (group 1) and those better than 20/200 (group 2). The primary outcome measures was best corrected visual acuity (logMAR) before surgery compared to visual acuity at postoperative months 1, 3 and 6. Fundus photography and optical coherence tomography (OCT) were analyzed.

Results: We were able to analyse 35 eyes, 17 under 20/200 and 18 eyes better at baseline. The mean duration of symptoms prior to surgery in these patients was 6 months. After surgery Mean BCVA of group 1 was 0.36 compared to 0.62 in group 2 (P=.002) at baseline; Mean BCVA postoperative at month 1 was 0.32 and 0.52 and Mean BCVA postoperative at month 6 was 0.32 in gr. 1 and 0.72 in group 2. The difference of BCVA was statistically significant at either months 1 or 6 Central macular thickness on OCT of patients decreased from a mean of 380 to 295 microns.

Conclusions: The development of BCVA after removal of epiretinal membranes and ILM appears to be a sign of chronicity on one hand. On the other hand the severity of retinal thickening measured by BCVA demonstrates outer retinal disorganization. BCVA therefore may be an important prognostic factor in electing patients for surgery.