Outcomes of pars plana vitrectomy for visually significant floaters in Northern Alberta

Vision degrading mydesposiae (VDM) can have a significant impact on a patient's quality of life. Pars plana vitrectomy (PPV) is a surgical modality used to treat a variety of vitreoretinal diseases and is an accessible treatment option for relief of VDM. This article analyzes outcomes and postoperative complications in a large, local sample of patients who have undergone PPV for symptomatic floaters from a northern Alberta perspective.

A retrospective chart review was conducted at Alberta Retina Consultants in Edmonton, Alberta. Patients who underwent PPV for VDM between 2017 and 2023 were identified. Only cases with floaters due to PVD and asteroid hyalosis were included; cases of prior vitrectomies, scleral buckle surgeries as well as cases of secondary myodesopsiae (i.e. uveitis) were excluded.

A total 452 eyes were identified and following application of exclusion criteria, 410 eyes of 308 patients were included. There were 157 male and 151 female patients with the average age of participants being 68 years (standard deviation (SD) ± 9). Vitrectomy was performed due to symptomatic PVD in 400 eyes (98%) with 10 eyes (2%) being symptomatic due to asteroid hyalosis. There were 181 phakic eyes (44%) and 229 eyes and pseudophakic eyes (56%). There were 26 patients (25.2%) who elected to undergo floaterectomy in the contralateral eye. There was no significant difference in visual acuity noted between preoperative and postoperative periods.

The current study supports PPV as an effective treatment option for symptomatic floaters. There was no statistically significant difference between preoperative and postoperative visual acuity. However, 29.9% of eyes underwent floaterectomy in the contralateral eye, which is in support of patient satisfaction. The observed complication rate was 7.3%, with retinal detachment being the most common complication. Of the 410 eyes, 30 eyes (7.3%) had postoperative complications which included adverse events that were recorded to have occurred between the immediate postoperative period and three years after vitrectomy. Complications include retinal detachment (2.4%), elevated IOP (1.5%), clinically significant cataract requiring surgery (1.5%), vitreous hemorrhage (0.73%), cystoid macular edema (0.98%), dislocated IOL (0.24%), endophthalmitis (0.24%) and epiretinal membrane (0.24). There was a statistically significant difference in visual acuity between preoperative and postoperative periods for eyes with complications.