Purpose
To assess the current attitudes, beliefs, and practice patterns among vitreoretinal surgeons when dealing with symptomatic floaters in patients with otherwise healthy eyes.
Methods
A cross sectional, internet-based, anonymous survey of 10 questions was distributed via e-mail to vitreoretinal specialists practicing in the United States.
Results
Overall, 159 surveys were completed. The first distribution returned 78 completed surveys (78/2600, 0.03%) over a three-week period; after individualized distribution, 81 additional surveys were completed (81/459, 17.6%) for a total response rate of 159/2600 (6.1%). 40/159 (25%) of respondents would perform pars plana vitrectomy (PPV) to reduce symptomatic floaters, and 110/159 (69%) had previously performed PPV for this indication. When compared to those unlikely to intervene for symptomatic floaters, 33/40 (83%) of those likely to intervene perform over 100 vitrectomy surgical cases annually (P<0.05). Between those that have and have not performed PPV for symptomatic floaters in the past, statistically significant differences were observed regarding the likelihood to perform PPV for symptomatic floaters in the future (35% vs. 4%; P<0.0001) and tendency to elect for a procedure if the surgeon’s own vision was impacted by symptomatic floaters (55% vs. 8%; P<0.001). When compared to those likely to perform surgery for symptomatic floaters, those unlikely to intervene identified three statistically significant barriers: the surgical risks involved with PPV (28% vs. 86%; P<0.001), unrealistic patient expectations (25% vs. 58%; P<0.001), and the possibility of ridicule from the local retina community (10% vs. 32%; P<0.01).
Conclusions
Vitreoretinal specialists are more likely to intervene for symptomatic floaters if they have previously done so and if they perform >100 surgical cases per year. 3 major barriers preventing physicians from performing an intervention for floaters: standard risks associated with PPV, the fear of unreasonable patient expectations, and the possibility of ridicule within the local retina community.