Vitrectomy in the management of peripheral uveitis

Abstract

The natural history of peripheral uveitis may eventually lead to indications for vitreous surgery. Over a 7-year period, a consecutive series of 12 eyes in nine patients with peripheral uveitis underwent vitreous surgery. Indications for surgery included persistent dense vitreous inflammation, vitreous hemorrhage, traction retinal detachment (RD), and epiretinal membrane formation. Patients were followed for an average of 22 months. Six eyes (50%) required further surgery after the development of RD, recurrent vitreous hemorrhage, or cataract formation. The preoperative finding most frequently associated with postoperative complications was the presence of active neovascularization of the vitreous base. Final visual acuity ranged from 20/30 to 20/100 showing an average improvement of 5 Snellen lines. Persistent cystoid macular edema significantly limited visual improvement in five patients. Patients undergoing vitreous surgery for management of peripheral uveitis may show a significant degree of visual improvement though multiple operations may be required. Control of active neovascularization is an important factor in limiting postoperative complications and the need for further surgery.