Safety of Vitrectomy for Floaters

Abstract

The risk profile of vitrectomy for floaters is comparable with that of vitrectomy for other elective indications. Retinal breaks are a common finding during surgery and treatment of these breaks is crucial for the prevention of postoperative retinal detachment. Patients considering surgery for floaters should be informed specifically about the risks involved.

Ageing of the vitreous: From acute onset floaters and flashes to retinal detachment

“…Intra-operative iatrogenic retinal breaks were found in 16.4% of patients and also retinal detachment occurred in 10.9% of cases (de Nie et al, 2013;Tan et al, 2011;Schulz-Key et al, 2011).…”

Vitrectomy for primary symptomatic vitreous opacities: an evidence-based review

“…In the study by de Nie et al, 21 of 50 eyes with clear lens before surgery, 19 eyes (38%) underwent cataract surgery during a period of 26.4 months. FOV with sparing of anterior vitreous is theoretically more lens friendly and the reported rate of cataract formation is lower at 23.5% (over 15 months) and 22.5% (over 18 months) in the two large studies by Sebag et al 39 and Mason et al 23 There is a great variation in literature in the incidence of RD post-PPV for SVO with figures ranging from 0, 2,32 2, 31 2.5, 6 6.7, 30 and 6.8%, 5 to as high as 10.9%. 21 Other complications following PPV for SVO include CMO (0.6-5.5%), 5,21,23 epiretinal membrane formation (1.3-3.6%), 6,21,39 transient vitreous haemorrhage (1.2%), 23 glaucoma (0.9%), 21 macular hole (0.9%), 21 and postoperative scotoma (0.9%).…”

“…This rate is less than that reported in literature (38-60%). 5,6,21 Also in this study the authors have not given the mean age of the phakic group, although the mean age of all patients in their study was 63 years (range 41-87 years). A quality of life survey in this group using a modified nine-QOL questionnaire showed that 96% of patients were satisfied with the surgery, with 94% calling it a complete success.…”

“…Surprisingly PVD induction was not considered a risk factor for retinal break formation in contrast to previous literature. 6,36 Again anterior hyaloid was left in situ, except in patients with retinal break formation, and only 22.5% of phakic patients developed a visually significant cataract requiring phacoemulsification during a mean follow-up of 18 months. This rate is less than that reported in literature (38-60%).…”

“…Hence treatment of the condition with its associated risks remains controversial. 6 In this manuscript, we aim to review the epidemiology, pathogenesis, clinical features, including impact on the quality of life, and the various treatment options available for SVO, with a special emphasis on safety, efficacy, and patient outcomes following vitrectomy for this condition.…”