Surgical Results in Ocriplasmin Candidates With Symptomatic Vitreomacular Traction Syndrome

• Published in: Current eye research Vol. 43; no. 2; pp. 208 - 212
• Main Authors: Vasquez, Dario H., Altamirano, Juan C., Casaus, Angel, Del Valle, Rodrigo A., Gonzalez, Roberto, Gonzalez-De La Rosa, Alejandro, Navarro-Partida, Jose, Vasquez, Martin A., Santos, Arturo
• Format: Journal Article
• Language: English
• Published: England Taylor & Francis 01.02.2018
• Subjects: Aged; Combined Modality Therapy; Eye Diseases - diagnostic imaging; Eye Diseases - physiopathology; Eye Diseases - surgery; Female; Fibrinolysin - administration & dosage; Fibrinolytic Agents - administration & dosage; Humans; Intravitreal Injections; macular hole; Male; metamorphopsia; Microsurgery; Middle Aged; ocriplasmin; Peptide Fragments - administration & dosage; Retina; Retinal Perforations - diagnostic imaging; Retinal Perforations - physiopathology; Retinal Perforations - surgery; Retrospective Studies; Tomography, Optical Coherence; Visual Acuity - physiology; Vitrectomy - methods; vitreomacular traction; Vitreous Body - diagnostic imaging; Vitreous Body - physiopathology; Vitreous Body - surgery; Retina; macular hole; vitreomacular traction; metamorphopsia; ocriplasmin
• ISSN: 0271-3683; 1460-2202
• DOI: 10.1080/02713683.2017.1385086

Purpose: To report surgical outcomes in a series of cases with symptomatic vitreomacular traction that met MIVI-TRUST (Microplasmin for intravitreous injection-traction release without surgical treatment) criteria for ocriplasmin use who underwent primary 25-gauge vitrectomy. Materials and Methods: A single-center retrospective chart review study was performed in patients who underwent primary 25-gauge vitrectomy for symptomatic vitreomacular traction (VTM) from January 2013 through January 2016. Pre- and postoperative visual acuity (measured by the early treatment diabetic retinopathy acuity test), and posterior hyaloid focal attachment to the macula (demonstrated by high-definition optical coherence tomography) were analyzed. In addition, intra- and postoperative complications were obtained from medical records. Results: Fifteen consecutive cases of symptomatic VMT traction that underwent primary 25-gauge vitrectomy were included. All met the MIVI-TRUST criteria for ocriplasmin use. In all cases, VMT resolution, macular hole closure, and improvement in best corrected visual acuity (BCVA) were observed. Mean visual acuity improved from 56.53 ± 16.04 letters at baseline to 73.13 ± 7.46 letters at 24 weeks of follow-up. The mean BCVA improvement from baseline was 16.60 letters (range 6-44), which was statistically significant (P < 0.0001). Ten of fifteen patients (66.6%) showed significant improvement of their BCVA to 20/40 or better (70 or more in ETDRS visual acuity test). No significant intra- or postoperative complications were documented. Conclusions: Primary 25-gauge pars plana vitrectomy in eyes with symptomatic vitreomacular traction is able to efficiently resolve VMT and macular holes, improving vision in candidates for intravitreal injection of ocriplasmin. This well-tolerated surgical procedure may be a reliable and predictable alternative for resolving VMT pathology.