Surgical Outcomes and Patient Satisfaction in Vitrectomy for Vitreous Floaters

Abstract

Purpose : Pars plana vitrectomy (PPV) is a common surgical procedure with a low rate of complications. We hypothesize that patients who undergo PPV for symptomatic vitreous floaters have a high level of satisfaction with surgery and demonstrate stable visual acuity (VA) with low rate of complications.

Methods : After IRB approval, we retrospectively analyzed all charts identified by a billing code search over 5 years from January 2011 through December 2016 in a single retinal specialty practice. We included patients with diagnoses of vitreous debris, posterior vitreous detachment (chronic), and asteroid hyalosis. Patients with coincident pre-existing diseases that did not affect VA, patients with intraoperative complications such as retinal tears, and patients who developed postoperative complications were included. We recorded best corrected VA at pre-op and 6 months post-op. VAs were converted to LogMar units for statistical analysis. We mailed surveys (5-point scale, 1=very negative to 5=very positive) to all patients in the summer of 2017. The surveys were based on the NEI-VFQ25 and designed to assess subjective improvement and level of satisfaction with surgery.

Results : We included 198 eyes of 151 patients: 59 right eye PPV, 45 left eye PPV, and 47 bilateral PPV on separate dates. Seventy-four eyes were phakic at time of surgery. Postoperative cataract was noted in 8.1% (6/74) of phakic eyes at 6 months post-op. No other significant complications were noted. There was a small improvement in best corrected VA between pre-op and 6 months post-op that was statistically significant (+0.118±0.12 LogMar units to +0.076±0.13 LogMar units respectively, p=0.0012).
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Survey response rate was 54% (82 surveys returned). Surveys demonstrated subjective stability in discomfort (mean 4.59 pre-op and 4.57 post-op), improvement in eyesight (mean 2.71 pre-op and 4.32 post-op), and improvement in difficulty with daily activities (mean 2.81 pre-op and 4.58 post-op). Overall patient satisfaction with the procedure was 71% very satisfied, 22% satisfied, 6% neutral, and 1% very unsatisfied.

Conclusions : Our results show that patients had a high level of satisfaction with PPV surgery for symptomatic vitreous floaters. The data also suggest a statistically significant result that shows a small potential improvement in VA (20/26 to 20/23 Snellen) for patients who undergo PPV. Further prospective studies would be reasonable.

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.