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M. A. von Fricken, N. Kunjukunju, G. Ko; Floaters: Surgical Management. Invest. Ophthalmol. Vis. Sci. 2009;50(13):4211.
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© ARVO (1962-2015); The Authors (2016-present)
To report on a controversial form of floater management. Floaters are annoying and disconcerting, but can also be potentially debilitating. Pars plana vitrectomy (PPV) was offered to patients to deal with the debilitating symptoms produced by floaters. Analysis includes visual outcomes, complications and patient satisfaction.
A retrospective, comparative analysis was performed after identifying patients who underwent vitrectomy surgery primarily for floaters. A single surgeon (MAV) at the same outpatient facility performed all surgeries. Variable and outcome measures included preoperative and postoperative vision, lens status, success rate and surgical complications. An analysis of 35 patients and 48 eyes were performed. This retrospective analysis was performed in conjunction with a telephone questionnaire to assess functional outcomes and patient satisfaction.
. Average pre-operative visual acuity was 20/26 and average post-operative visual acuity was 20/27 (p-value 0.78). Of the 48 cases, 6 patients developed intra-operative breaks that were treated with laser. One patient developed a "macula-off" retinal detachment, but regained 20/20 vision after surgery. Each patient interviewed stated that they were unhappy with the quality of vision prior to surgery and each one felt that the quality of their vision improved after surgery. The quality of vision prior to surgery was commonly referred to as poor, stressful or annoying. The most commonly reported daily activity that was affected was reading, followed by driving. None of the phakic patients stated that knowledge of eventual cataract surgery affected their decision regarding vitrectomy. When asked if this was a surgery they would repeat, 94.74% of respondents affirmed yes and would refer friends.
Currently the role of vitrectomy in floater management is controversial. The advice commonly given to patients is to ignore the floater. Floaters can affect quality of life. In this small, retrospective study, all patients were significantly dissatisfied with their quality of life and bothered enough by their symptoms to undergo elective vitrectomy. Average patient vision pre-operatively in this study was 20/26, however when the floater was obstructing the center of their vision they were unable to read or drive. The p-values of the pre-operative and post-operative improvements in reading and driving as obtained via telephone questionnaire were significant. This study is subject to the limitations inherent by design, but does however suggest the viability of vitrectomy as a treatment alternative to floaters.
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