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Abstract
Purpose: to evaluate and compare the safety and efficacy of two surgical techniques for patients with ischemic CRVO. The first technique was pars plana vitrctomy while in the second technique, radial optic neurotomy (RON) was done after vitrectomy. In both techniques 4 mg of triamcinolone acetonide (TA) was injected into the vitreous cavity at the end of the surgery.
Methods: a prospective randomized controlled study. Thirty eyes of 30 patients with ischemic CRVO of less than 6 weeks duration were randomly divided into 2 groups (15 patients in each one). The patients were followed clinically and with fluorescein angiography and OCT for 6 months after surgery. Differences in the best corrected visual acuity (BCVA) and central macular thickness (CMT) between both groups were recorded.
Results: no complications were encountered during surgery in group A (without RON) while in group B (with RON), intraretinal hemorrhage was found at the RON site in 2 (13.3%) patients. Retinal dialysis at sclerostomy site occurred in one (6.7%) patient and was treated successfully. Marked anatomic improvement was noted in most patients of both groups and documented via fundus photography and fluorescein angiography. In group A, the mean baseline BCVA was slightly less than 6/240 and it improved to 6/160 six months after surgery, with two eyes (13.3%) had a final BCVA better than 6/60. On the other hand, 26.7% (4/15) of patients had equal acuity. Two (13.3%) patients had worse acuity. In group B, the mean baseline BCVA was slightly less than 6/240 and it improved to 6/180 six months after surgery with only one (6.7%) eye in this group had a final BCVA better than 6/60. On the other hand, 4 (26.7%) patients had worse acuity. The difference in the final BCVA between both groups was not statistically siginifcant.