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S. Schulz-Key, J.-O. Carlsson, S. Crafoord; Do Patients With Vitreoretinal Floaters Benefit From Pars Plana Vitrectomy? Long-Term Follow-Up of Outcome, Complications and Patient Satisfaction. Invest. Ophthalmol. Vis. Sci. 2009;50(13):4199.
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To report the long-term outcome of vitrectomy for vitreous floaters and to evaluate patients symptoms and satisfaction.
Retrospective chart review of 79 consecutive cases that were vitrectomised for non-inflammatory vitreous opacities with a follow-up time of 6-108 month (mean 37 month). An author generated questionnaire was completed at the end of follow-up time.
Mean best corrected visual acuity (BCVA) improved slightly from 0.81 Snellen preoperatively to 0.87 after vitrectomy. This change was not statistically significant (p=0.07). 60% of the phakic patients were operated for cataract during follow-up. One patient had a retinal detachment at postoperative day 1 (1.3%). 4 retinal detachments occurred late in the follow-up period after 24-44 month postoperatively (5.0%). One patient needed several reoperations including silicone oil in order to reattach the retina and had a final VA of 0.5. The other detachments were reattached with one procedure and had a VA of 1.0 at the end of follow-up. Two patients with no prior history of inflammation developed on both eyes a strong inflammatory reaction postoperatively. One of them developed long lasting hypotony and sterile hypopyon but regained full VA. The other developed bilateral chronic macular edema and vision remained at BCVA 0.3. The questionnaire revealed substantial visual difficulties due to the vitreous opacities preoperatively despite good VA. 85% of the patients stated that the floaters disappeared completely after the vitrectomy. 3 of 4 patients experienced a general improvement of vision. 88% were satisfied with the results of the operation.
Some patients experience considerable disturbances of vision due to vitreous floaters. They appear to benefit from vitrectomy to a large extent in our study. The patient selection is crucial. All history and signs of inflammation have to be ruled out. An increased risk for retinal detachment several years after vitrectomy have to be taken into account.
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