Vitrectomy for severe Coats′ disease

Objective To investigate the outcome of vitreoretinal surgery for severe Coats′ disease Methods From December 1995 to December 1999, trans pars plana vitrectomy was performed in 11 patients (11 eyes) diagnosed as Coats′ disease Ten of them were complicated with total retinal detachment, and the other one had tractional retinal detachment caused by epiretinal proliferation All these patients were followed up from 3 months to 4 5 years Results All of the patients obtained useful vision except 1 patient whose operation was given up because of severe shortening of the retina Three patients had the visual acuity higher than 0 02, and the best vision was 0 2 Obliteration of all abnormal vessels and resorption of all exudate was found postoperatively from 1 month to 3 months Although the retina had been reattached in 10 patients during the operation, re detachment was found in 4 patients postoperatively After therapy all re detached retina was reattached The success rate was 90 9% Conclusions Vitrectomy with endolaser or scleral cryotherapy is an ideal therapy for severe Coats′ disease, although the visual prognosis is still limited It can preserve the limited vision, and prevent the severe complications such as rubeosis iridis, glaucoma, and phthisis bulbi