Wavefront Aberrometry in Pseudophakic Patients Before and After Vitrectomy for Bothersome Floaters

Introduction: To investigate whether the outcome of patients with persistent bothersome floaters who are managed with vitrectomy can be correlated with improvements in higher-order aberrations with wavefront aberrometry. Methods: Pseudophakic patients who had 27-gauge vitrectomy for persistent floaters and whose clinical assessment included preoperative and postoperative wavefront aberrometry were included. The primary outcome was the change in the higher-order aberration percentage measured by wavefront aberrometry. Results: The study included 76 eyes of 66 patients with a mean age (±SD) of 67.8 ± 7.5 years. The Snellen visual acuity improved from 20/32 preoperatively to 20/25 postoperatively (P = .004). Wavefront aberrometry showed a highly significant reduction in the higher-order aberration percentage (P < .000001), with a mean preoperative percentage of 53.9 and a mean postoperative percentage of 38.3. Subgroup analysis found a significant reduction in patients with no previous posterior capsulotomy (P = .001), previous neodymium:YAG capsulotomy (P < .000001), a monofocal intraocular lens (IOL) (P < .000001), and a multifocal IOL (P = .006). There was no significant difference in the mean preoperative and postoperative pupil size, sphere, cylinder, or spherical equivalent. Conclusions: Wavefront aberrometry demonstrates an objective, significant reduction in higher-order aberrations immediately after vitrectomy in pseudophakic patients with bothersome floaters.