This paper presents a meta-analysis and systematic review of the safety and efficacy of vitrectomy for vitreomacular traction (VMT), based on 21 eligible articles from 460 identified. A strength of this study is that it provided pooled analysis across a range of studies using standardised data collection and predefined outcome measures. Regarding efficacy it was found that approximately one third of eyes gained two snellen lines (0.25 logMAR lines gain on average). The authors emphasised that these visual gains might be less than anticipated. Patients who complained preop with distortion may find surgery beneficial despite unchanged visual acuity, if distortion is reduced postop. Safety seems to be acceptable. The commonest intraop complication is spontaneously resolving intraretinal haemorrhage. Postoperative retinal detachment occurred in 4.6% which is higher than expected and may be explained by the fact that in VMT the vitreous is attached and posterior vitreous detachment (PVD) intraop induction increases the iatrogenic risk of retinal breaks. Two thirds of phakic patients required cataract surgery after VMT surgery as expected (known risk of 69% to require cataract surgery in two years after pars plana vitrectomy (PPV).

Pars plana vitrectomy for vitreomacular traction syndrome.
Jackson T, Nicod E, Angelis A, et al.
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Nikolaos D Georgakarakos

Moorfields Eye Hospital, London, UK.

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