Recently we have seen that the use of ocriplasmin may cause undesired effects. New option (air, different intraocular gases) seem to be very successful. What is your first choice, if you want active intervention?
Dear Prof. Gerding
In context of the surgical success rate of more than 95 % success to remove vitreoretinal traction on the macula I like to perform sutureless 23 G vitrectomy in such cases. within the frame of german re-imbursement system in ambulant surgery this is with limited costs of 1500 Euro compared to 40% success (in best cases) for 2200 Euro for the ocriplasmin including the procedure. I like to control the risk of retinal detachment that I had with ocriplasmin (also with vitrectomy) but when incipient under surgery I treat it immedaitely but not with delay
First option is always PPV. With superior instrumentation and use of intraoperative OCTs my first choice is PPV. If there is financial restraint then intraocular gas tamponade maybe attempted. Success rate of ocriplasmin in OASIS trial are equivocal and should be avoided given the cost and many vision threatening complications.
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