Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Department of Ophthalmology, Tel Aviv-Sourasky Medical Center, Tel Aviv, Israel.
Clin Interv Aging. 2018 Feb 9;13:243-249. doi: 10.2147/CIA.S154425. eCollection 2018.
To evaluate visual and surgical outcomes in very elderly patients (above 85 years of age) undergoing pars plana vitrectomy (PPV).
A single-center, retrospective study was carried out on the medical records of 82 patients aged 85 years and older who had undergone PPV from 2006 to 2013. Patients ranged in age from 86 to 99 years, with a mean age of 88.9 years (±2.88). Visual results and intraoperative and postoperative complications were the main outcome measures. Visual improvement/worsening was defined as at least ±0.1 logMAR change.
Mean follow-up was 7.25 months (±5.35), with a range of 1-28 months. General anesthesia was used in 63% of the operations. The most common indication was retinal detachment (27%). The ocular condition necessitating PPV was secondary to trauma (most commonly after a fall) in 10 eyes (12%). Mean visual acuity (VA) improved from 1/58 preoperatively to 1/29 at the final evaluation (=0.014). Mean improvement in VA in eyes of patients with the comorbidity of age-related macular degeneration (n=34) was 41% lower compared to eyes of patients without the disease (n=48, =0.013). In the subgroup of patients operated on for retinal detachment, 45.4% did not reach primary anatomic success and 45.4% needed additional retina-affecting surgery. One or more major ocular complications were reported in 24 eyes (29%), while 19 eyes (23%) had minor ocular complications.
Improved VA was documented in more than half of the older adults aged 85-99 undergoing vitrectomy. Despite the rate of complications in the very elderly, the possibility of optimizing visual function may positively affect quality of life in this subgroup.
评估 85 岁以上行玻璃体切除术（PPV）的超高龄患者的视力和手术结果。
对 2006 年至 2013 年期间行 PPV 的 82 例 85 岁及以上患者的病历进行了单中心回顾性研究。患者年龄 86 至 99 岁，平均 88.9 岁（±2.88）。主要观察指标为视力结果、术中及术后并发症。视力改善/恶化定义为至少±0.1 logMAR 变化。
平均随访 7.25 个月（±5.35），随访时间为 1-28 个月。63%的手术采用全身麻醉。最常见的适应证是视网膜脱离（27%）。10 只眼（12%）因眼部情况需要行 PPV，其原因为创伤（最常见于跌倒后）。术前最佳矫正视力（BCVA）为 1/58，最终评估时为 1/29（=0.014）。与无年龄相关性黄斑变性（AMD）的患者（n=48，=0.013）相比，合并 AMD 的患者（n=34）视力改善程度低 41%。在因视网膜脱离而接受手术的患者亚组中，45.4%未达到初次解剖学成功，45.4%需要进行额外的视网膜手术。24 只眼（29%）报告了 1 种或多种主要眼部并发症，19 只眼（23%）有轻微眼部并发症。
在接受玻璃体切除术的 85-99 岁老年人中，超过一半的患者视力得到改善。尽管超高龄患者的并发症发生率较高，但改善视力功能的可能性可能会积极影响该亚组的生活质量。
