Predictors of visual outcomes and recurrence after pars plana vitrectomy for uveitis: A 3-Year longitudinal cohort study

Uveitis is a chronic relapsing inflammatory disease that often requires long-term systemic immunomodulatory (IMD) therapy. Pars plana vitrectomy (PPV) is increasingly used as an adjunctive treatment for selected uveitis cases; however, robust long-term evidence remains limited. This retrospective cohort study evaluated 3-year outcomes in 159 uveitic eyes undergoing PPV and a reference group of 22 eyes receiving medical therapy alone to assess visual, anatomical, and systemic treatment burden changes. Following PPV, best-corrected visual acuity (BCVA) improved significantly and remained stable through 36 months (P < 0.001). Central macular thickness decreased from 326.8 to 288.4 μm (P < 0.001), and the proportion of eyes with vitreous haze < grade 1 increased from 24.5% to 90.0%. Systemic corticosteroid doses and the number of IMD agents were significantly reduced at 36 months (both P < 0.001), whereas these improvements were not observed in the reference group. Multivariable analyses identified worse baseline BCVA and higher preoperative intraocular pressure as predictors of poorer visual outcomes. Higher preoperative corticosteroid dose (> 15 mg/day) was associated with improved visual recovery but increased recurrence risk. These findings suggest that PPV is associated with durable visual and inflammatory improvements, and a reduction in systemic treatment burden in uveitic eyes.