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G. J. Burrell, S. M. Hariprasad, W. F. Mieler, R. D. Jager; Improvement in Visual Quality of Life After Traditional and Microincisional Vitrectomy Surgery. Invest. Ophthalmol. Vis. Sci. 2008;49(13):5970.
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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.
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.
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).
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.
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