gms | German Medical Science

102. Jahrestagung der DOG

Deutsche Ophthalmologische Gesellschaft e. V.

23. bis 26.09.2004, Berlin

Subgroup-analysis of the available literature about the effect of vitrectomy in uveitis on macular edema

Meeting Abstract

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  • corresponding author N. Harsch - Interdisciplinary uveitis center Heidelberg
  • F.G. Holz - University Eye Hospital Bonn
  • M. Zierhut - University Eye Hospital Tübingen
  • M.D. Becker - Interdisciplinary uveitis center Heidelberg

Evidenzbasierte Medizin - Anspruch und Wirklichkeit. 102. Jahrestagung der Deutschen Ophthalmologischen Gesellschaft. Berlin, 23.-26.09.2004. Düsseldorf, Köln: German Medical Science; 2004. Doc04dogP 212

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Veröffentlicht: 22. September 2004

© 2004 Harsch et al.
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Over the last 25 years 60 papers have been published dealing with therapeutic vitrectomy in uveitis. So far no prospective, controlled clinical trials have been performed to precisely evaluate the role of pars plana vitrectomy (PPV) as a single or combined surgical procedure in patients with intraocular inflammation. It is the purpose of this study to present available information from the medical literature and summarize our current recommendations concerning vitrectomy on uveitic cystoid macular edema (CME).


A total of 60 publications from 1979 to 2003 about therapeutic vitrectomy were included into the analysis. 1728 patients had been included into all studies and 1934 eyes had been vitrectomized. All publications were analysed and compared concerning anatomical localization, functional results, influence on the activity of intraocular inflammation, preoperative risc factors, influence on macular edema, type of immunosuppression, number of combined procedures, postoperative complications as well as quality of life.


71% of vitrectomized eyes showed improvement of V/A after PPV according to the authors individual definition and judgment about improvement of V/A and non-standardized detection of CME. In 18% of eyes there was no change and 11% of eyes deteriorated. CME was reduced from preoperatively 41% to 20% postoperatively. Five papers especially analyzed the effect of PPV on CME (140 patients with 182 vitrectomized eyes). In this subgroup of papers only 47% of patients improved in V/A, while 38% showed no change and 18% deteriorated. However, CME was reduced from 100% preoperatively to 40% postoperatively in the CME-subgroup of published articles. Unfortunately, the detection of CME was done in a non-standardized fashion, what makes it difficult to compare the individual papers.


It has been controversially discussed if PPV can improve the presence of a cystoid macula edema (CME) postoperatively. Since PPV can also induce a CME in uveitis patients months after the procedure it is recommended to perform PPV only in patients where an adequate immunosuppressive treatment and therapy with acetazolamide before surgery did not reduce the CME.