Purpose
To report outcomes in eyes treated by pars plana vitrectomy (PPV) for visually significant, symptomatic vitreous floaters (SVF).
Methods
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.
Results
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.
Conclusions
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.