Vitrectomy in the Treatment of Uveiti

Purpoe To ae the evidence that par plana vitrectomy (PPV) i ueful in improving viion, reducing dieae activity, or ameliorating cytoid macular edema (CME) in patient with uveiti. Deign Review of the literature. Method A Medline earch wa conducted for relevant article publihed in Englih, German, or French. Article were analyzed for content and evidence level. Reult A total of 44 interventional cae erie publihed between 1981 and 2005 were identified that included 1575 patient (1762 eye). Evidence level wa grade CII-3 indicating poibly improved clinical outcome with fair or poor evidence. The average age of patient wa 36 year with a median duration of uveiti before urgery of 48 month and a median follow-up of 1.9 year. Intermediate uveiti wa preent in 841 eye. Cytoid macular edema and cataract were common co-morbiditie, and there were large number of additional urgical procedure. Viual outcome in 39 article were tated a improved in 708 eye (68%), unchanged in 202 eye (20%), and worened in 124 eye (12%). Reduction in ytemic medication following PPV wa reported in 25 tudie. The median reported percentage of patient per tudy with CME wa 36% preoperatively and 18% potoperatively. Concluion Baed on the evidence in the literature, PPV i poibly relevant to the outcome of improving viion and reducing inflammation and CME. Randomized, controlled, collaborative trial or hypothei-baed cae erie with precie outcome meaure that incorporate control group would improve the quality of evidence upporting PPV a an adjunct to the medical treatment of uveiti.