Vitrectomy provides relief from severe floaters

Fort Lauderdale, FL-Patients with severe floaters had marked improvements in visual acuity and quality of life after undergoing vitrectomy to remove vitreous floaters and debris, according to John O. Mason III, MD.

Patients with floaters have symptoms because retinal straylight caused by light scattering leads to glare, hazy vision, and loss of contrast, said Dr. Mason, Department of Ophthalmology, University of Alabama at Birmingham.

Previous management in these patients included observation and YAG laser therapy. However, YAG laser was beneficial for only 38% of patients, carried a risk of retinal detachment ranging from 0.5% to 4.16%, and could not be performed if the collagen fibers were close to the lens or retina. In the future, intravitreal injection of medications to liquefy the vitreous cavity may become available.

Dr. Mason and colleagues conducted a single-center, retrospective study that included 143 patients who underwent small-gauge sutureless vitrectomy between 2008 and 2010. This surgery is associated with less trauma and a low risk of development of endophthalmitis (0.053%), he noted. Patients also completed nine questions in a quality-of-life survey.

Preoperatively, 64% of patients (average age, 63 years) reported severe difficulties with reading, 38% severe difficulties with driving, 15% occupational difficulties, and 10% problems with leisure activities. Most patients had floaters resulting from partial posterior vitreous detachments.

Following surgery 94.2% of patients were very satisfied with the surgical results.

“Almost all patients had increased or stabilized vision,” Dr. Mason said. “Most patients had no or mild symptoms after surgery.”

No choroidal hemorrhages, endophthalmitis, or retinal detachments developed postoperatively.

“Small-gauge pars plana vitrectomy should be considered a viable alternative for patients with impaired quality of life resulting from severe vitreous floaters or vitreous debris,” Dr. Mason concluded.

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