23G pars plana vitrectomy for vitreal floaters: prospective assessment of subjective self-reported visual impairment and surgery-related risks during the course of treatment

Graefes Arch Clin Exp Ophthalmol. 2018 Jun;256(6):1089-1099. doi: 10.1007/s00417-018-3979-8. Epub 2018 Apr 30.

Abstract

Purpose: Quantifying the subjective impairment due to floaters based on an indication-specific questionnaire and setting its change between prior to and 3/12 months after elective vitrectomy in relation to surgical risks.

Methods: Single-arm longitudinal observational multicenter study. Sixty-four floater patients underwent 23G pars plana vitrectomy; simultaneous phacoemulsification was excluded. An overall self-rated impairment index (SRI) and sub-indices SRI were calculated on the basis of a modified Visual Quality of Life questionnaire (VQoL), which addresses general vision, glare, near-sight problems and mobility of floaters. SRI ranged from 0 to 100% (maximum impairment). Secondary endpoints included corrected visual acuity and complications.

Results: Data were collected prior to and 3 (n = 64) and 12 (n = 62) months after surgery. The median overall SRI improved (44, 12, 11%) with a statistically significant median reduction of 69% (95% confidence interval 50-89%) 3 months postop. The median sub-SRIs improved for glare (50, 17, 17%), near sight problems (50, 17, 8%), and mobility of floaters (43, 5, 0%). Sixteen eyes needed cataract surgery during follow-up (10 showed cataract already prior to vitrectomy). Eight complications were reported (6 intra-operative retinal holes, 2 post-operative retinal detachments).

Conclusion: For the majority of floater patients, subjective impairment was profoundly reduced by vitrectomy. Benefits of surgery prevailed despite complications.

Keywords: Floaters; Mouches volantes; Pars Plana vitrectomy; Prospective multicenter study; Quality of life; Subjective impairment.

Publication types

  • Multicenter Study
  • Observational Study

MeSH terms

  • Female
  • Follow-Up Studies
  • Germany / epidemiology
  • Humans
  • Incidence
  • Intraoperative Complications / epidemiology*
  • Male
  • Postoperative Complications / epidemiology*
  • Prospective Studies
  • Quality of Life
  • Retinal Detachment / epidemiology
  • Retinal Perforations / epidemiology
  • Risk Assessment*
  • Self Report
  • Time Factors
  • Vision, Low / epidemiology
  • Vision, Low / etiology*
  • Vision, Low / physiopathology
  • Visual Acuity*
  • Vitrectomy / methods*
  • Vitreous Body / pathology*
  • Vitreous Body / surgery