Abstract
Purpose :
Pars plana vitrectomy (PPV) is a frequently performed procedure utilized to address various vitreoretinal conditions such as rhegmatogenous retinal detachment (RRD), diabetic tractional retinal detachment (TRD), vitreous hemorrhage (VH), and choroidal detachment. Despite advancements in vitrectomy techniques, there is limited research on the visual prognosis for individuals with no light perception (NLP) vision before surgery. This study evaluates the visual outcomes of eyes with NLP vision during the pre-vitrectomy examination and identifies factors associated with post-surgical vision recovery.
Methods :
A retrospective chart review of all patients scheduled for PPV with NLP vision at their preoperative visit from January 2015 to December 2023 was conducted. Demographic, preoperative, and postoperative data were collected. The main outcome measures were visual acuity (VA) at post-operative periods day 1, week 1, months 1, 3, 6, 12, final visit, date of first VA better than NLP post PPV, and date of best VA post PPV. VA was converted to logarithm of minimum angle of resolution (logMAR), and the Wilcoxon signed-rank test was used to analyze non-parametric data for paired samples to assess changes in VA.
Results :
A total of 35 patients with NLP vision at baseline prior to surgery were included in the study. The median age was 60 (interquartile range = 34-79), median duration of follow-up (months) was 13 (interquartile range = 6-38), and 21 of the 35 subjects (60%) were male. The mean preoperative VA was 3±0. The mean best VA after surgery was 2.24±0.81. In this study, 26 of 35 eyes (74.3%) regained vision better than NLP. Of these 26 eyes that saw improvement, the mean best VA after surgery was 1.98±0.78. A statistically significant median VA from baseline to all post-operative periods was observed (p ≤ 0.001). The median days to recovery of VA better than NLP post PPV was 1 (interquartile range = 1-7), and the median days to recovery of VA to the best value post PPV was 39 (interquartile range = 5.5-114.75). One eye with VH and TRD and PDR (94.1%) had the most improvement in VA post PPV. One eye with a retained lens fragment and TRD and one eye with VH and TRD saw no improvement in VA from baseline.
Conclusions :
PPV may improve visual outcomes in patients with NLP vision at baseline, suggesting the potential benefits of vitrectomy in patients with severe visual impairment.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.