23G pars plana vitrectomy for vitreal floaters: prospective assessment of subjective self-reported visual impairment and surgery-related risks during the course of treatment
- 26 Downloads
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.
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.
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).
For the majority of floater patients, subjective impairment was profoundly reduced by vitrectomy. Benefits of surgery prevailed despite complications.
KeywordsFloaters Mouches volantes Pars Plana vitrectomy Prospective multicenter study Quality of life Subjective impairment
The authors thank Dr. NA Frost for the permission to use the Visual Quality of Life questionnaire for developing the Floaters questionnaire. Furthermore, the authors are grateful to Mrs. Nicole Waack for study coordination, to Mrs. Levka Dahmen for assistance in data management, and to Mrs. Tara Rödter and to Mrs. Chui Lai Choo-Ludwig for revising the paper focusing on syntax as well as comprehensibility.
The OcuNet Trial Group thank Alcon Pharma GmbH, Freiburg, for supporting the study financially.
Participating study physicians
Dr. H. Kaymak, Gerl-Gruppe, Augenklinik Ahaus, Ahaus
Prof. K. Ludwig, Ober Scharrer Gruppe, ARIS MVZ Nuremberg, Nuremberg
Dr. O. Cartsburg, Augen-Zentrum-Nordwest, Augenpraxis Ahaus, Ahaus
Dr. A. Lommatzsch, Augenärzte am St. Franziskus Hospital, Muenster
Dr. T. Littan, Augenpraxisklinik Lohr, Lohr
Dr. U. Weigmann, Augenklinik Dr. Hoffmann, Braunschweig
Dr. P. Requat, Augenklinik Dr. Hoffmann, Braunschweig
Dr. A. Bunse, Augenärzte Hamburg-Bergedorf, Dr. Bunse Dr. Elsner Dr. Pörksen, Hamburg
Dr. S. Spang, Augen-Partner-Gruppe, Augenzentrum Tuttlingen, Tuttlingen
This study was funded by Alcon Pharma GmbH, Freiburg: funding was used for clinical project management resources and administrated by U Hahn (OcuNet).
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The coordinating Independent Ethics Committee (Bavaria) gave unrestricted consent to the investigation design at hand by its vote in 08 / 2011; so did all local Committees subsequently in accordance with this vote.
Informed consent was obtained from all individual participants included in the study.
- 2.Sebag J (1989) The vitreous—structure, function an pathobiology. Springer-Verlag, New YorGoogle Scholar
- 6.Koo EH, Haddock LJ, Bhardwaj N, Fortun JA (2016) Cataracts induced by neodymium-yttrium-aluminium-garnet laser lysis of vitreous floaters. Br J Ophthalmol https://doi.org/10.1136/bjophthalmol-2016-309005
- 10.Schulz-Key S, Carlsson JO, Crafoord S (2011) Longterm follow-up of pars plana vitrectomy for vitreous floaters: complications, outcomes and patient satisfaction. Acta Ophthalmol https://doi.org/10.1111/j.1755-3768.2009.01682.x
- 18.Garcia GA, Khoshnevis M, Yee KM, Nguyen-Cuu J, Nguyen JH, Sebag J (2016) Degradation of contrast sensitivity function following posterior vitreous detachment. Am J Ophthalmol https://doi.org/10.1016/j.ajo.2016.09.005