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Hari Mylvaganam, James M. Osher, Michael M. Lai; Vitrectomy for Symptomatic Vitreous Floaters: Characteristics of Intraocular Lens Status and Patient Selection, a Retrospective Observational Study. Invest. Ophthalmol. Vis. Sci. 2017;58(8):2807.
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To determine whether patients with multifocal intraocular lenses (MFIOLs) or accommodative lenses have a shorter duration, from symptom onset to intervention, of symptomatic floaters.
Patient charts reviewed over a 45-month period. Patients that were selected were those that underwent pars plana vitrectomy (PPV) for symptomatic floaters. All patients were not satisfied with their vision due to floaters, with complaints ranging from glare, haloes, and spots in their vision.The type of intraocular lens was recorded (monofocal, multifocal, or accommodating IOL) in patients who were pseudophakic at initial examination. Length of symptoms were measured by date of initial exam to the date of PPV. Visual acuity, intra- and post-op complications, including retinal detachments (RD), and cataract formation were recorded.
Two hundred and four eyes of 153 patients underwent PPV for floaters. Seventy-three eyes were phakic and 131 eyes were pseudophakic, of these pseudophakic eyes 19 of them had either a MFIOLs (n=14) or an accommodating Crystalens (n=5). The mean length of symptoms prior to surgery was 22.67 months (range 2-240 months) for all patients. However, the time interval between symptoms onset and PPV for phakic patients was much longer at 36.01 months and much shorter in MFIOL or accommodating pseudophakes (13.32 months).Of the all eyes that underwent PPV, there was 1 RD, 1 retinal hole, 1 case of endophthalmitis, 4 cases of cystoid macula edema, 1 branch retinal artery occlusion. Intra-op retinal tears were identified in 7 eyes (3.4%), two of which had PVD induction (p<0.05). There was no statistically significant difference for intraoperative retinal tears based on lens status. Twenty three of 67 phakic eyes (34%) had cataract surgery after PPV with a mean time of 8.5 months. Forty-four eyes remained phakic and of these 14 eyes showed signs of progression (31%) of their cataract, and 30/44 (68%) did not show any progression.
Our study highlights an observation that MFIOL/accommodative IOL patients had a shorter duration of floater onset to PPV than phakic or monofocal IOL patients. This possibly suggests MFIOLs might exacerbate the symptoms of floaters. Future studies, with a larger cohort of MFIOL patients, would be beneficial to further elicit the significance of these lenses on floaters.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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