Two-port vitreomacular surgery in the treatment of patients with epiretinal fibrosis

Abstract

Perpose. To present a method of two-port vitrectomy in treatment of patients with epiretinal fibrosis. Material and methods. Two-port vitrectomy method was used to treat patients with idiopathic epiretinal fibrosis. The group included 25 patients (25 eyes) – 16 (64 %) women and 9 (36 %) men. The mean age of the patients was 61 ± 6.4 years. Exclusion criteria were glaucoma and concomitant retinal pathology. The mean value of best corrected visual acuity was 0.28 ± 0.07. The mean retinal thickness in the fovea was 417 ± 70 µm. Vitrectomy was performed with installation of two ports in the opposite quadrants – in the lower half for high-flow cannula (illuminator-chandelier built with infusion cannula), in the upper half for vitrectomy cutter and instruments. The High-Flow infusion cannula (Synergetics) integrated with the mercury vapor illuminator-chandelier is connected to the Photon II illumination system (Synergetics). Surgery was performed classically: central vitrectomy, separation of posterior hyaloid membrane, staining of membranes with vitral dye, membrane removal, tamponade ⅓ of vitreous cavity with sterile air. The average operation time was 18 minutes. Results. Six months after the operative treatment all patients noted reduction of visual discomfort and severity of metamorphopsies. Best corrected visual acuity was increased – 0.58 ± 0.1 (p ≤ 0,05 vs. preoperative values). Average retinal thickness in the fovea after surgical treatment decreased to 261 ± 25 µm according to macular OCT chart (p = 0.03). FCM readings were consistent with preoperative 5.1 ± 2.3 f/ms (p ≤ 0.01). Conclusion. The method of two-port vitrectomy with the use of mercury vapor chandeleur in the treatment of vitreomacular pathology allows safe and effective macular surgery. Keywords: retinophototoxicity, vitrectomy, epiretinal fibrosis