"Pneumatic vitreolysis has a CPT code-67025-almost as much as vitrectomy." "These have to be motivated patients," he said. For patients with a macular hole, they must stay face down for 45 minutes every hour for the first 3 days postoperatively. ![]() Mein creates an anterior chamber paracentesis, injects 0.3 cc of C3F8 at 12 o'clock. The surgical technique is an in-office procedure using subconjunctival anesthesia.ĭr. Best spectacle-corrected visual acuity (BSCVA) was performed at baseline and at each follow-up visit, Dr. Patients with macular hole were asked to maintain face-down positioning for at least 4 days. "All patients were required to avoid supine position after receiving 0.3 mL C3F8 gas injection until gas resolution."Īmong the exclusion criteria was previous retinal surgery (with the exception of prior ocriplasmin use) and any conditions deemed possible to confound the results (e.g., advanced cataract or advanced macular pathologic condition). "We performed a retrospective study on patients with focal VMT who underwent PVL in 2 centers from 2010 to 2017," he said. Pneumatic vitreolysis is an intravitreal injection of a small quantity of expansile gas for the purpose of achieving focal VMT release, or for inducing VMT release and the close of a macular defect for eyes with a small stage-2 macular hole, Dr. Mein said.Ĭoncerns about the use of ocriplasmin and its potential side effects have led to pneumatic vitreolysis being suggested as an alternative. Management for symptomatic VMT includes observation, vitrectomy, and intravitreal injection of ocriplasmin, Dr. ![]() Under specific circumstances, tractional forces associated with progression of VMT may lead to the development of a full-thickness macular hole and further vision loss. Newer technologies, such as optical coherence tomography (OCT), have allowed clinicians to more readily and easily diagnose VMT. Mein, of Retinal Consultants of San Antonio. VMT is caused by an anomalous posterior vitreous separation with vitreous traction that distorts the foveal architecture, explained Dr. Treating symptomatic vitreomacular traction (VMT) with pneumatic vitreolysis and limited face-down positioning "is a highly effective emerging technique for achieving VMT release (86%) for focal VMT, with a respectable macular hole closure rate of 62%," said Calvin Mein, MD.
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