Current surgical management of the vitreous wick syndrome

We successfully treated three consecutive cases of the vitreous wick syndrome by combining repair of the fistula with closed vitrectomy to remove vitreous gel from the anterior chamber and from the internal aspect of the fistula. In two cases, the fistula seemed to be formed by the tract of an externally tied corneoscleral suture. In two cases the external opening of the fistula was large, and we covered it by a partial-thickness, anteriorly hinged scleral flap. One patient developed an epithelial ingrowth, which was successfully treated by transscleral and transcorneal cryotherapy combined with the use of an intraocular gas bubble to provide a thermal insulating effect to enhance the cryotherapy.