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Matthew Starr, Ross Chod, Levent Akduman; Analyzing the safety and efficacy of Pars Plana Vitrectomy for Symptomatic Vitreous Floaters. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):5099.
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© ARVO (1962-2015); The Authors (2016-present)
To report outcomes in eyes treated by pars plana vitrectomy (PPV) for visually significant, symptomatic vitreous floaters (SVF).
Retrospective chart review performed on 39 eyes of 33 patients. Demographic data, pre- and post-operative best corrected visual acuity (BCVA) - reported as logMAR visual acuity (LMVA) - subjective improvement, side effects, and complications were analyzed.
Mean patient age was 59.5 years (range: 24-85 years). Mean follow-up time was 641 days (range: 8 days to 8.9 years).<br /> <br /> BCVA improved or remained stable relative to baseline in 35 of 39 eyes. Mean post-op BCVA for all patients was improved from baseline (pre-op LMVA: 0.14 (SD 0.17); post-op LMVA: 0.075 (SD 0.18), p=0.01). The average number of additional lines read in 20 eyes demonstrating improvement was 1.6 lines (SD=0.68). 15 eyes had pre-op BCVA of 20/20: 13 remained 20/20 at final follow-up (FFU); 2 demonstrated a decline in BCVA of 1 and 2 lines at FFU.<br /> <br /> 21 eyes were phakic at the time of vitrectomy. 11 phakic eyes had PPV alone, 10 had combined PPV and cataract extraction (PPV/CE). Final BCVA after PPV alone was stable relative to baseline (pre-operative LMVA: 0.14 (SD 0.2); post-operative LMVA: 0.15 (SD 0.31), p = 0.38). A trend of improvement in BCVA was noted in the PPV/CE group (pre-operative LMVA: 0.15 (SD 0.12); post-operative LMVA: 0.075 (SD 0.1), p=0.077).<br /> <br /> 18 eyes were pseudophakic at the time of vitrectomy. 6 pseudophakic eyes had PPV alone, 12 had combined PPV and posterior capsulectomy (PPV/PC). Final BCVA after PPV alone was improved from baseline at FFU (pre-op LMVA: 0.14 (SD 0.19); post-op LMVA: 0.05 (SD 0.12), p=0.02). The PPV/PC group demonstrated a trend toward improvement (pre-op LMVA: 0.15 (SD 0.13); post-op LMVA: 0.049 (SD 0.05); p=0.07).<br /> <br /> 90% of all patients endorsed subjective improvement from baseline. 7 of the 11 (64%) phakic eyes that had PPV alone required subsequent CE (average time to CE: 3.3 years). Complications included 1 intra-operative retinal tear and 2 post-op vitreous hemorrhages requiring repeat PPV (complication rate of 8.05%). 2 eyes (5.1%) required repeat PPV for recurrent floaters.
Our results suggest that PPV is a safe and effective therapy for patients with SVF. Statistical analysis demonstrates improvement or preservation of BCVA in all groups analyzed and a high rate of subjective improvement of the visual experience post-operatively.
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