25-gauge vitrectomy and triamcinolone acetonide-assisted internal limiting membrane peeling for chronic cystoid macular edema associated with branch retinal vein occlusion.

Purpose: To evaluate the efficacy of 25-gauge vitrectomy and triamcinolone acetonide (TA)-assisted internal limiting membrane (ILM) peeling for chronic cystoid macular edema (CCME) in branch retinal vein occlusion (BRVO). Methods: Thirty-four patients (38 eyes) presenting with CCME in BRVO were treated prospectively by 25-gauge vitrectomy and ILM peeling. Change in best-corrected visual acuity (BCVA) and CCME status were evaluated preoperatively and postoperatively at 1 month, 2 months, 3 months, 4 months, 5 months, 6 months, and 7 months. Results: Mean postoperative logMAR BCVAs +/- SD were 0.69 +/- 0.42, 0.65 +/- 0.41, 0.59 +/- 0.32, 0.39 +/- 0.27, 0.35 +/- 0.31, 0.32 +/- 0.28, and 0.32 +/- 0.31 at the seven follow-up months, respectively. Mean foveal thicknesses +/- SD were 443 +/- 60 mu m, 212 +/- 67 mu m, 188 +/- 41 mu m, 176 +/- 53 mu m, 173 +/- 41 mu m, 171 +/- 39 mu m, and 170 +/- 41 mu m at the 7 follow-up months, respectively. Compared with before surgery, BCVA improved, and CCME was absorbed significantly (P < 0.01, Dunnett test). Foveal thickness and logMAR BCVA 7 months after surgery had a significant negative linear correlation (r = -0.81, P < 0.01; Spearman rank correlation). Conclusions: Twenty-five-gauge vitrectomy with TA-assisted ILM peeling is generally effective in reducing macular edema and improving BCVA for CCME in BRVO for at least 7 months.