Pars Plana Vitrectomy With in Vivo Cyst Lysis for Intraocular Cysticercosis.

BACKGROUND AND OBJECTIVE: To evaluate efficacy and safety of pars plana vitrectomy (PPV) and in vivo cyst lysis for intraocular cysticercosis.

PATIENTS AND METHODS: Retrospective analysis of the records of 15 patients undergoing PPV for intraocular cysticercosis at a tertiary eye care center was done. All patients had undergone in vivo cyst lysis. Of these 15 patients, one had intravitreal cysticercosis (IVC) with vitritis, two cases had IVC with vitritis with tractional retinal detachment (TRD), four cases had subretinal cysticercosis (SRC), four cases had SRC with extensive fibrosis without TRD, and five cases had SRC with fibrosis with TRD. Postoperative visual acuity at 3 months of follow-up was analyzed as the primary outcome measure.

RESULTS: Mean age of patients was 26 years ± 12.27 years. Four out of 15 patients were female. Mean preoperative best-corrected visual acuity (BCVA) was 1.55 logMAR units ± 0.62 logMAR units, whereas mean postoperative BCVA at last follow-up (3 months) was 1.26 logMAR units ± 0.65 log-MAR units. Mean visual gain (0.29 logMAR units) post-surgery was statistically significant (P = .018). The final visual acuity correlated with preoperative BCVA with Pearson's coefficient being 0.78 (95% CI, 0.44-0.92; P = .001). Anatomical success was achieved in 13 of 15 (87%) cases. In one case the cyst was dead and calcified and could not be removed. TRD was associated with poor visual gain.

CONCLUSION: Intravitreal cyst lysis is a safe and successful approach for managing intraocular cysticercosis. Visual results depend on preoperative condition. TRD implicates poor visual prognoses. [Ophthalmic Surg Lasers Imaging Retina. 2016;47:665-669.].