Abstract:

Objective To explore the clinical effects of vitrectomy through adjusted scleral incisions on ocular toxocariasis. Design Retrospective case series. Participants 139 patients (139 eyes) with ocular toxocariasis who underwent vitrectomy with adjusted scleral incisions in Beijing Tongren Hospital between March 2012 to March 2018 and with a postoperative follow-up of at least 5 months were included. Methods The medical records of the patients including general information, results of preoperative ultrasonic bimicroscope (UBM) examination, surgical approaches, pre- and post-operative visual acuity and anatomical changes were retrospectively described. Postoperative visual acuity improvement was defined as two or more lines better than before；and postoperative visual acuity deterioration was defined as two or more lines worse than before；stable postoperative visual acuity was defined as changes no more than one lines. Main Outcome Measures Pre- and post-operative visual acuity, anatomical changes and complications. Results 46.0%（64/139 eyes） of the patients underwent vitrectomy combined with lensectomy. The follow-up-time was 29±9 months. At last follow-up, visual acuity improved in 85 eyes (85/121, 70.2%)，remained stable in 27 eyes (27/121，22.3%) and deterioration in 9 eyes (9/121，7.5%); 99 eyes (96/139, 69.1%) had tractional retinal detachment preoperatively, among which 65 eyes had retinal reattachment or partial retinal reattachment. Postoperative hypotony within 1 week and postoperative ocular hypertension after 1 month were most common complications. Conclusion Vitrectomy through adjusted scleral incisions assisted by preoperative UBM seems to be beneficial for the short-term prognosis of visual acuity and anatomic outcomes of ocular toxocariasis. Preoperative UBM seems to valuable in detecting the extent and range of peripheral vitreoretinal pathologies of ocular toxocariasis and assisting in selecting the optimum location of scleral incisions.

Key words: ocular toxocariasis/surgery, vitrectomy, scleral incision