Karunatilake Malshi, Fijardo Brendon, Michael Eugene, Somani Rizwan
Department of Ophthalmology and Visual Sciences, University of Alberta, Royal Alexandra Hospital, 2319 Active Treatment Centre, 10240 Kingsway Avenue NW, Edmonton, AB, T5H 3V9, Canada.
Alberta Retina Consultants, 10924 107 Ave NW #400, Edmonton, AB, T5H 0X5, Canada.
Int J Retina Vitreous. 2025 May 6;11(1):54. doi: 10.1186/s40942-025-00676-3.
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.
视力下降性飞蚊症（VDM）会对患者的生活质量产生重大影响。玻璃体切割术（PPV）是一种用于治疗多种玻璃体视网膜疾病的手术方式，也是缓解VDM的一种可行治疗选择。本文从阿尔伯塔省北部的角度分析了大量接受PPV治疗有症状飞蚊症的本地患者的治疗结果和术后并发症。
在阿尔伯塔省埃德蒙顿的阿尔伯塔视网膜咨询中心进行了一项回顾性病历审查。确定了2017年至2023年间因VDM接受PPV的患者。仅纳入因玻璃体后脱离（PVD）和星状玻璃体病变导致飞蚊症的病例；排除既往有玻璃体切割术、巩膜扣带手术以及继发性飞蚊症（即葡萄膜炎）的病例。
共确定452只眼，应用排除标准后，纳入308例患者的410只眼。有157例男性和151例女性患者，参与者的平均年龄为68岁（标准差（SD）±9）。400只眼（98%）因有症状的PVD进行了玻璃体切割术，10只眼（2%）因星状玻璃体病变出现症状。有181只眼（44%）为有晶状体眼，229只眼为无晶状体眼（56%）。有26例患者（25.2%）选择对侧眼行飞蚊切除术。术前和术后视力无显著差异。
本研究支持PPV作为有症状飞蚊症的有效治疗选择。术前和术后视力无统计学显著差异。然而，29.9%的眼对侧眼行飞蚊切除术，这支持了患者的满意度。观察到的并发症发生率为7.3%，视网膜脱离是最常见的并发症。在410只眼中，30只眼（7.3%）有术后并发症，包括记录在玻璃体切割术后即刻至术后三年期间发生的不良事件。并发症包括视网膜脱离（2.4%）、眼压升高（1.5%）、需要手术的具有临床意义的白内障（1.5%）、玻璃体积血（0.73%）、黄斑囊样水肿（0.98%）、人工晶状体脱位（0.24%）、眼内炎（0.24%）和视网膜前膜（0.24%）。有并发症的眼术前和术后视力有统计学显著差异。
