RECURRENT FLOATERS AFTER LIMITED VITRECTOMY FOR VISION DEGRADING MYODESOPSIA.


Journal

Retina (Philadelphia, Pa.)
ISSN: 1539-2864
Titre abrégé: Retina
Pays: United States
ID NLM: 8309919

Informations de publication

Date de publication:
01 07 2023
Historique:
medline: 22 6 2023
pubmed: 21 3 2023
entrez: 20 3 2023
Statut: ppublish

Résumé

Limited vitrectomy improves vision degrading myodesopsia, but the incidence of recurrent floaters postoperatively is not known. We studied patients with recurrent central floaters using ultrasonography and contrast sensitivity (CS) testing to characterize this subgroup and identify the clinical profile of patients at risk of recurrent floaters. A total of 286 eyes (203 patients, 60.6 ± 12.9 years) undergoing limited vitrectomy for vision degrading myodesopsia were studied retrospectively. Sutureless 25G vitrectomy was performed without intentional surgical posterior vitreous detachment (PVD) induction. CS (Freiburg Acuity Contrast test: Weber index, %W) and vitreous echodensity (quantitative ultrasonography) were assessed prospectively. No eyes (0/179) with preoperative PVD experienced new floaters. Recurrent central floaters occurred in 14/99 eyes (14.1%) without complete preoperative PVD (mean follow-up = 39 months vs. 31 months in 85 eyes without recurrent floaters). Ultrasonography identified new-onset PVD in all 14 (100%) recurrent cases. Young (younger than 52 years; 71.4%), myopic (≥-3D; 85.7%), phakic (100%) men (92.9%) predominated. Reoperation was elected by 11 patients, who had partial PVD preoperatively in 5/11 (45.5%). At study entry, CS was degraded (3.55 ± 1.79 %W) but improved postoperatively by 45.6% (1.93 ± 0.86 %W, P = 0.033), while vitreous echodensity reduced by 86.6% ( P = 0.016). New-onset PVD postoperatively degraded CS anew, by 49.4% (3.28 ± 0.96 %W; P = 0.009) in patients electing reoperation. Repeat vitrectomy normalized CS to 2.00 ± 0.74%W ( P = 0.018). Recurrent floaters after limited vitrectomy for vision degrading myodesopsia are caused by new-onset PVD, with younger age, male sex, myopia, and phakic status as risk factors. Inducing surgical PVD at the primary operation should be considered in these select patients to mitigate recurrent floaters.

Identifiants

pubmed: 36940362
doi: 10.1097/IAE.0000000000003781
pii: 00006982-202307000-00008
pmc: PMC10293082
mid: NIHMS1878325
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1114-1121

Subventions

Organisme : NIBIB NIH HHS
ID : R01 EB032082
Pays : United States

Déclaration de conflit d'intérêts

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Références

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Auteurs

Stefaniya K Boneva (SK)

VMR Institute for Vitreous Macula Retina, Huntington Beach, California.
Doheny Eye Institute, UCLA, Pasadena, California.
Eye Center, Medical Center, Faculty of Medicine, University of Freiburg, Germany.

Justin H Nguyen (JH)

VMR Institute for Vitreous Macula Retina, Huntington Beach, California.

Wei Gui (W)

VMR Institute for Vitreous Macula Retina, Huntington Beach, California.

Cameron Hoerig (C)

Department of Radiology, Weill-Cornell Medicine, New York, New York.

Jonathan Mamou (J)

Department of Radiology, Weill-Cornell Medicine, New York, New York.

Jeffrey A Ketterling (JA)

Department of Radiology, Weill-Cornell Medicine, New York, New York.

Lawrence P Chong (LP)

VMR Institute for Vitreous Macula Retina, Huntington Beach, California.
Keck School of Medicine, University of Southern California, Los Angeles, California.

J Sebag (J)

VMR Institute for Vitreous Macula Retina, Huntington Beach, California.
Doheny Eye Institute, UCLA, Pasadena, California.
Department of Ophthalmology, David Geffen School of Medicine, UCLA, Los Angeles, California.

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