Patient-Reported Outcomes after Surgery for Proliferative Vitreoretinopathy: Post hoc Analysis of a Randomized...

Introduction: Proliferative vitreoretinopathy (PVR) is the leading cause of surgical failure in rhegmatogenous retinal detachment (RRD) and is associated with poor visual prognosis. We aimed to report changes in VFQ-25 and SF-36 tests following surgery for PVR-RRD and identify clinical and demographic factors associated with recovery.

This is a post hoc analysis of a phase IIIb randomized, participant-masked clinical trial evaluating slow-release dexamethasone in PVR-RRD. Patients underwent pars plana vitrectomy with silicone oil tamponade. Vision-related QOL was assessed using VFQ-25, and SF-36 test, at baseline, 6 months, and 12 months postoperatively. VFQ-25 subscales and SF-36 domains were analysed descriptively and with nonparametric paired tests; associations with best-corrected visual acuity (BCVA, logMAR) and other variables were assessed using Spearman correlation and nonparametric tests.

A total of 139 patients were included (mean age 61 years; 60% male). VFQ-25 total score improved from a median of 65.5 at baseline to 70 at 12 months (p = 0.0004). SF-36 total score improved from 68 to 77.5 at 12 months (p = 0.006). Worse 12-month BCVA correlated with lower VFQ-25 (p < 0.001) and showed a borderline association with SF-36 (p = 0.054). In univariable analyses, women reported lower 12-month QOL; however, gender associations were attenuated in multivariable models (VFQ-25: β = -4.39, p = 0.073; SF-36: β = -4.71, p = 0.199). Retinal anatomical status and number of surgeries were not associated with QOL outcomes. Subscale/domain analyses showed the largest improvements in psychosocial domains: VFQ-25 mental health increased from 50.0 to 68.8 (p = 3.35 × 10-5), and SF-36 mental health increased from 68.0 to 80.0 (p = 2.38 × 10-6), while most physical health domains were stable.

Despite the complexity of PVR-RRD, significant improvements in both visual function and general QOL were observed postoperatively driven largely by psychosocial recovery. Final BCVA and baseline QOL had a greater influence on perceived recovery than anatomical success or number of surgeries. These findings highlight the importance of personalized care and rehabilitation in managing PVR-RRD patients.