Vitrectomy Research Paper

Furthermore, it has been demonstrated that improvements in VA following vitrectomy for VMT are better in patients with a shorter duration of symptoms prior to surgery.146
PPV is the current standard of care for VMT with ‏MH.130 One study utilising modern techniques reported an MH closure rate of 84%,147 a large review of the National Ophthalmology Database (NOD) reported VA improvement of >2 Snellen lines in 49% of eyes at 12 weeks after surgery for VMT with ‏MH.102 It has been demonstrated that delaying vitrectomy is associated with worse outcomes compared with prompt intervention. One study showed that, in patients with VMT with ‏MH of <6 months’ duration, successful closure was achieved in 95% of patients compared with 47% in patients with
The probability of successful MH closure decreased by 6% with each month of delay prior to surgery.106 In addition, specific to VMT without MH, it has been suggested that excessive traction upon the fovea and its deformation can lead to structural changes that may not recover completely, either anatomically or functionally, after vitreous release. In one study, 69 cases of VMT that had recently converted from VMA were observed over a 2-year period; eight developed epiretinal membrane (ERM), six of which underwent vitrectomy with symptoms of reduced VA and metamorphopsia, five underwent cataract surgery, two developed MH, and one developed lamellar MH, whereas one patient had surgery to remove a dropped nucleus.148 The evolving evidence therefore suggests that observing VMT may result in progression of vitreomacular interface diseases, such as ERM, which can negatively impact success rates of subsequent intervention, highlighting the importance of considering early intervention in this group of symptomatic patients. Even with modern approaches, PPV may be associated with retinal detachment (7%), chronic intraocular pressure elevation (6%), and cystoid macular oedema (5%).149 In the NOD study,