Surgical results in the vitreomacular traction syndrome

Abstract

Purpose: The vitreomacular traction syndrome is a distinct clinical entity in which partial posterior vitreous detachment is present in combination with persistent macular adherence, causing traction-induced visual deficit. The authors evaluate the results of vitreous surgery for this syndrome.

Methods: The authors reviewed 20 consecutive eyes that underwent vitrectomy and posterior hyaloid/epiretinal membrane stripping to better define the clinical features, visual results, and complications of surgery for the vitreomacular traction syndrome.

Findings: Eyes were categorized anatomically as having either "classic" vitreomacular traction syndrome (8 [40%] eyes had 360 degrees midperipheral vitreous detachment) or "variable" vitreomacular traction syndrome (12 [60%] eyes had a variety of midperipheral areas of vitreous separation). Release of vitreomacular traction resulted in improvement in vision of two or more lines in 15 (75%) eyes, with 8 (40%) obtaining 20/50 visual acuity or better. All eyes were followed for at least 6 months. Complications of vitreous surgery included progression of nuclear sclerosis (83% of phakic eyes), epiretinal membrane formation (40%), and retinal breaks (20%).

Conclusion: The vitreomacular traction syndrome represents a wide spectrum of vitreoretinal anatomic configurations that can produce visual deficit. Vitrectomy surgery to release macular traction may improve visual acuity.