This paper reports the outcomes of microincision vitreous surgery (MIVS) 23G/25G in uveitis of 103 patients (106 eyes) who underwent diagnostic MIVS over a period of four years at the Advanced Eye centre in Chandigarth India. The postoperative evaluation included visual acuity, vitreous haze and complications. The mean follow-up period was 12.2+/-7.2 months (median 12 months) and the mean age was 36.8+/-13.9 years. Mean best corrected visual acuity (BCVA) was 1.5+/-1.0 logMAR preop and 0.72+/-0.68 logMAR at one month (p=0.000). The postoperative complications included – cataract (14.6%), rise in intraocular pressure (13.2%), vitreous haemorrhage (4.7%) hypotony (3.2%), retinal detachment (2.8%), epiretinal membrane (2.8%) and worsening of inflammation (0.9%). There was a significant reduction in vitreous haze postoperatively as early as the next postoperative day. The mechanism by which vitrectomy improves inflammation is not known precisely. Removal of the vitreous that harbours the inflammatory cells / mediators (immune complexes and cytokines) and infectious agents may be responsible for eliminating inflammation. Additionally the authors reported the reduction or cessation in the use of postoperative steroids systemic corticosteroids (or tapered to a low dose <7.5 mg/day) in 67.8% eyes. Overall, the authors found MIVS to be safe and efficacious and well tolerated in the majority of eyes in a wide variety of complicated uveitis cases. 

Safety and outcome of microincision vitreous surgery in uveitis.
Bansal R, Gupta A, Gupta V et al.
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Nikolaos D Georgakarakos

Moorfields Eye Hospital, London, UK.

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