Anatomiska och funktionella resultat efter behandling av vitreomakulär traktion/adhesion (VMA/VMT) med vitrektomi eller ocriplasmin (Jetrea®)

Background: Vitrectomy is a well-accomplished method for treatment of vitreomacular traction. In 2013, a new approach for treating symptomatic vitreomacular traction was presented, ocriplasmin (Jetrea®), that could perform enzymatic vitreolysis. In this study ocriplasmin was studied to compare the t...

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Bibliographic Details
Main Author: Dukay, Maria
Format: Others
Language:Swedish
Published: Örebro universitet, Institutionen för medicinska vetenskaper 2021
Subjects:
Online Access:http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-93319
Description
Summary:Background: Vitrectomy is a well-accomplished method for treatment of vitreomacular traction. In 2013, a new approach for treating symptomatic vitreomacular traction was presented, ocriplasmin (Jetrea®), that could perform enzymatic vitreolysis. In this study ocriplasmin was studied to compare the treatment results with the standard method vitrectomy. Aim: The purpose of this study was to compare vitrectomy to ocriplasmin-injection for treatment of vitreomacular traction performed between 2013 and 2016. Materials and methods: The medical records of 16 patients were reviewed. Eight of them were treated with ocriplasmin and the other eight underwent vitrectomy due to vitreomacular traction. All patients who received ocriplasmin at the clinic were included, and vitrectomy-patients were matched to these according to sex, age and visual acuity. Preoperative and postoperative symptoms, visual acuity and optical coherence tomography findings were analyzed. Results: Vitreomacular traction resolved in every eye treated with vitrectomy compared to four of eight eyes treated with ocriplasmin. With one exception, every patient´s visual acuity in the vitrectomy group improved, with a mean value of +0,223 Snellen. Three of eight patients in the ocriplasmin group had improved visual acuity, while three worsened and two remained the same. Visual acuity in this group altered with a mean value of +0,071 Snellen. Conclusions: Enzymatic vitreolysis is a good idea, but according to our and other international studies, it only achieves good results in half of the cases, while vitrectomy almost always succeeds. Although vitrectomy can lead to certain complications, for example cataract, it is a well functioning and relatively moderate surgical procedure and its complications can be managed.