Pars plana vitrectomy for central retinal artery occlusion without emboli

Abstract

Purpose: The results of patients who had 23-G pars plana vitrectomy (PPV) unresponsive to medical therapy for central retinal artery occlusion without visible embolization are presented. Materials and Methods: We operated on eight patients who were treated for acute central retinal artery occlusion without visible emboli in our clinic. We started emergency medical treatment following diagnosis which was unsuccessfull. Afterwards, the patient had PPV in six cases and PPV- trabeculectomy in two cases. During the operation we applied intraoperative hypotonia for ten minutes and we tried to restore retinal circulation with fluid turbulance on optic nerve head. While visual acuity remained at the basal level in five patients (hand movement positive), slight increase was observed in three patients (preop P (-), 20 cmFC, 2 mFC, ; postop 30 cmFC, 30 cmFC, 0.1 respectively). Discussion and Conclusion: Primary pars plana vitrectomy and surgical hypotonia may be an early treatment option for central retinal artery occlusion without visible emboli, which should be evaluated in large scale studies.