Author: Haroon Tayyab
Co-authors:
Abstract
Purpose: To evaluate the efficacy of pars plana vitrectomy and internal membrane peel (ILM) and tuck in the pit for improving structural and functional outcomes.Setting: We describe 6 consecutive cases of optic disc pit maculopathy operated between 2018 and 2021 at The Aga Khan University Hospital, Pakistan.
Methods: All cases were treated with 25G pars plana vitrectomy with ILM flap tucked in the pit. All cases received a single row of confluent laser (barely visible) burns at the temporal margin of the optic disc pit followed by isovolumetric Sulphur hexafluoride gas tamponade. All cases were followed for one year and structural (pre and post-surgical optical coherence tomography images) and functional outcomes were documented.
Results: In this study, four patients were males and two females. All patients were operated by single surgeon using a uniform surgical technique. Their pre and post-operative visual outcomes were recorded periodically and at 12 months. Patient 1 aged 34 had a pre-operative best corrected visual acuity (BCVA) of 20/80 improving to 20/25 and improvement in central macular thickness (CMT) (pre-operative: 842um; post-operative: 226um) . Second patient was a 27-year-old with pre-operative BCVA of 20/30 which improved to 20/20 and improvement in CMT (pre-operative: 731um; post-operative: 341um). Third patient was 41 years old with pre-operative BCVA of 20/100 and post-op BCVA of 20/30 and improvement in CMT (pre-operative: 690 um; post-operative: 160um). Fourth patient was 35 years old with pre-operative BCVA of 20/200 improving to 20/40 and improvement in CMT (pre-operative: 891um; post-operative: 185um). Fifth patient was 46 years old with pre-operative BCVA of 20/150 improving to 20/30 and improvement in CMT (pre-operative: 729um; post-operative: 210um). Sixth patient was 51 years old with pre-operative BCVA of 20/80 improving to 20/20 and improvement in CMT (pre-operative: 560um; post-operative: 197um). One patient still had intraretinal edema at 12 months follow up. There were no other significant complications. There were no cases of recurrences.
Conclusions: Pars plana vitrectomy with nasal ILM tuck in the optic pit is a safe surgical technique with satisfactory anatomical and functional results at a follow up of 12 months.
