Abstract
Purpose: :
To compare the effects of 20-, 23-, and 25-gauge pars plana vitrectomy (PPV) on vision-related quality-of-life (VR-QOL) and explore the association between self-reported visual quality-of-life and objective measures of visual function.
Methods: :
Thirty-one eyes (of 31 patients) were prospectively chosen to undergo 20-gauge, 23-gauge, or 25-gauge vitrectomy. The National Eye Institute’s 25-Item Visual Function Questionnaire (VFQ-25) was administered to all study patients pre-operatively as well as ten days, one month, and four months post-operatively. Multi-item scales rating different aspects of VR-QOL were compared at each interval, and their correlation to objective visual test performance before and after surgery was analyzed.
Results: :
Patients in all three surgical groups exhibited similar baseline values, both in terms of VR-QOL and objective visual acuity tests. In the ten-day post-operative period, patients who received microincisional vitrectomy surgery (MIVS, 23- or 25-gauge) exhibited significantly better improvement in the areas of general vision (p=0.038), ocular pain (p=0.043), distance activities (p=0.046), dependency (p=0.029), and overall VR-QOL (p=0.008) than patients who received the traditional 20-gauge procedure. In the one-month post-operative period, patients receiving MIVS exhibited significantly better improvement in the areas of ocular pain (p=0.047) and distance activities (p=0.044) than their traditional vitrectomy counterparts, but did not exhibit significantly better improvement in composite VFQ scores (p=0.269). After four months, the only significant improvement which arose between microincisional and 20-gauge patients was in their ease and comfort with driving (p=0.037).
Conclusions: :
In cases where traditional and microincisional vitrectomy are equally plausible, microincisional surgery can offer patients reduced pain, greater independence, and a better subjective perception of their vision in the immediate post-operative period.
Keywords: vitreoretinal surgery • quality of life