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Journal of Ophthalmology 2017To report the surgical outcomes of 27-gauge pars plana vitrectomy (PPV) for symptomatic vitreous floaters.
PURPOSE
To report the surgical outcomes of 27-gauge pars plana vitrectomy (PPV) for symptomatic vitreous floaters.
METHODS
47 eyes of 47 patients (39 males, 83.0%) with symptomatic vitreous floaters who underwent 27-gauge PPV and followed up for more than 6 months were included. The mean age was 34.7 ± 13.5 years.
RESULTS
No operative complication occurred. At first day postoperatively, the intraocular pressure (IOP) was significantly lower than that at other time points (8.6 ± 2.7 mmHg, < 0.001). 28 (59.6%) eyes had transient hypotony (IOP < 8 mmHg). All were recovered within 1 week postoperatively. The BCVA of 41 eyes (41/47, 87.2%) remained unchanged or improved. Postoperative complications occurred in two eyes: one (2.1%) had endophthalmitis and one (2.1%) had retinal detachment. No clinical significant cataract was observed in the 42 postoperative phakic eyes. 91.5% of the patients were satisfied with the surgery outcome. Besides, 91.3% of the patients felt that the floaters were removed completely or only had an acceptable residual.
CONCLUSION
Visual acuity of most patients remained unchanged or improved following 27-gague pars plana vitrectomy for symptomatic vitreous floaters, resulting in high patient satisfaction. However, this treatment should be performed with great caution since severe postoperative complications may still occur. This trial is registered with NCT03049163.
PubMed: 29318039
DOI: 10.1155/2017/5496298 -
European Journal of Ophthalmology Apr 2021The treatment of floaters has consisted primarily of monitoring. The therapeutic approach is based on surgical removal or Nd:YAG laser treatment. The objective of this...
BACKGROUND
The treatment of floaters has consisted primarily of monitoring. The therapeutic approach is based on surgical removal or Nd:YAG laser treatment. The objective of this study was the assessment of the quality of life in patients treated with Nd:YAG laser for floaters.
METHODS
Single-center pretest-posttest design in a cohort of subjects treated with Nd-YAG laser with Ultra Q-Reflex technology. Health-related quality of life of the patients was measured before and after the intervention with the Visual Function Questionnaires VFQ-25 and VFQ-39. Anxiety level was measured with the State-Trait Anxiety Inventory. Visual acuity, contrast sensitivity, and safety parameters were also considered.
RESULTS
Thirty-four patients were included in the study. For the VFQ-25 baseline, the median was 73.05, interquartile range (19.25) versus a final median value of 93.76 (8.73) with < 0.01. The baseline median for the extended version VFQ-39 was 74.60 (19.01) versus the final median of 95.01 (6.50) with < 0.001. Regarding the anxiety, according to the STAI questionnaire, there were statistically significant differences between the baseline and the final conditions, with a baseline median of 38 (11) versus a final median of 18 (19); < 0.001. When the analyses differentiated between patients with and without myopia, there were statistically significant differences for VFQ-25 and VFQ-39.
CONCLUSIONS
This study shows an improvement in the health-related quality of life and a significant decrease in anxiety for patients that have undergone Nd: YAG Ultra-Q Reflex laser vitreolysis for floaters vaporization. The effect found is higher in myopic patients.
PubMed: 33827286
DOI: 10.1177/11206721211008036 -
JAMA Ophthalmology Sep 2017Vitreous floaters are common and can worsen visual quality. YAG vitreolysis is an untested treatment for floaters. (Comparative Study)
Comparative Study Randomized Controlled Trial
IMPORTANCE
Vitreous floaters are common and can worsen visual quality. YAG vitreolysis is an untested treatment for floaters.
OBJECTIVE
To evaluate YAG laser vitreolysis vs sham vitreolysis for symptomatic Weiss ring floaters from posterior vitreous detachment.
DESIGN, SETTING, AND PARTICIPANTS
This single-center, masked, sham-controlled randomized clinical trial was performed from March 25, 2015, to August 3, 2016, in 52 eyes of 52 patients (36 cases and 16 controls) treated at a private ophthalmology practice.
INTERVENTIONS
Patients were randomly assigned to YAG laser vitreolysis or sham YAG (control).
MAIN OUTCOMES AND MEASURES
Primary 6-month outcomes were subjective change measured from 0% to 100% using a 10-point visual disturbance score, a 5-level qualitative scale, and National Eye Institute Visual Functioning Questionnaire 25 (NEI VFQ-25). Secondary outcomes included objective change assessed by masked grading of color fundus photography and Early Treatment Diabetic Retinopathy Study best-corrected visual acuity.
RESULTS
Fifty-two patients (52 eyes; 17 men and 35 women; 51 white and 1 Asian) with symptomatic Weiss rings were enrolled in the study (mean [SD] age, 61.4 [8.0] years for the YAG laser group and 61.1 [6.6] years for the sham group). The YAG laser group reported greater symptomatic improvement (54%) than controls (9%) (difference, 45%; 95% CI, 25%-64%; P < .001). In the YAG laser group, the 10-point visual disturbance score improved by 3.2 vs 0.1 in the sham group (difference, -3.0; 95% CI, -4.3 to -1.7; P < .001). A total of 19 patients (53%) in the YAG laser group reported significantly or completely improved symptoms vs 0 individuals in the sham group (difference, 53%; 95% CI, 36%-69%, P < .001). Compared with sham, NEI VFQ-25 revealed improved general vision (difference, 16.3; 95% CI, 0.9-31.7; P = .04), peripheral vision (difference, 11.6; 95% CI, 0.8-22.4; P = .04), role difficulties (difference, 17.3; 95% CI, 8.0-26.6; P < .001), and dependency (difference, 5.6; 95% CI, 0.5-10.8; P = .03) among the YAG laser group. Best-corrected visual acuity changed by -0.2 letters in the YAG laser group and by -0.6 letters in sham group (difference, 0.4; 95% CI, -6.5 to 5.3; P = .94). No differences in adverse events between groups were identified.
CONCLUSIONS AND RELEVANCE
YAG laser vitreolysis subjectively improved Weiss ring-related symptoms and objectively improved Weiss ring appearance. Greater confidence in these outcomes may result from larger confirmatory studies of longer duration.
TRIAL REGISTRATION
clinicaltrials.gov NCT02897583.
Topics: Adult; Aged; Double-Blind Method; Eye Diseases; Female; Humans; Laser Therapy; Lasers, Solid-State; Male; Middle Aged; Sickness Impact Profile; Surveys and Questionnaires; Visual Acuity; Vitrectomy; Vitreous Body; Vitreous Detachment
PubMed: 28727887
DOI: 10.1001/jamaophthalmol.2017.2388 -
Internal Medicine Journal Apr 2012A 72-year-old female presented with a 6-month history of bilateral floaters and visual blurring. Clinically, the posterior vitreous was cellular bilaterally, with no...
A 72-year-old female presented with a 6-month history of bilateral floaters and visual blurring. Clinically, the posterior vitreous was cellular bilaterally, with no signs of subretinal infiltrates, retinal vasculitis, disc oedema or macula oedema. A vitreous biopsy and vitrectomy were scheduled following left cataract surgery because of the presence of a dense cataract. One month after cataract surgery, the patient developed signs of florid left arteritis involving the first-order branches of the central retinal artery. A 23-gauge vitreous biopsy and vitrectomy were performed, and preservative-free triamcinolone was injected. Cytology of the biopsy demonstrated benign T-lymphocytes and histiocytes suggestive of mild chronic inflammation only. Magnetic resonance imaging (MRI) of the brain was normal as was lumbar puncture. Subsequently, the patient developed right upper motor neuron facial nerve palsy. MRI imaging on this occasion demonstrated multiple hyper-intense white matter lesions. A third MRI was subsequently obtained due to new neurological deficits and demonstrated enlargement of the pre-existing lesions. Brain biopsy confirmed the presence of primary cerebral lymphoma. The present case highlights the role of various tissue biopsies, including vitreous, cerebrospinal fluid and brain tissue, to establish an elusive diagnosis of primary central nervous system lymphoma presenting as benign vitreous floaters.
Topics: Aged; Brain Neoplasms; Diagnosis, Differential; Female; Humans; Lymphoma; Magnetic Resonance Imaging; Vitreous Body
PubMed: 22498134
DOI: 10.1111/j.1445-5994.2011.02689.x -
Journal of Personalized Medicine Oct 2022With the rapid development of display technology, related diseases of the human eye are also increasing day by day. Eye floaters are one of the diseases that affect...
With the rapid development of display technology, related diseases of the human eye are also increasing day by day. Eye floaters are one of the diseases that affect humans. Herein, we present a functional ophthalmic dressing that can permeate the skin tissues of the eyes through oxygen and hydrogen to improve the symptoms of floaters. In clinical tests, the symptoms of sensory floaters improved in 28 patients, and the recovery rates of mild, moderate, and severe floaters were about 70%, 66.7%, and 83.3%, respectively.
PubMed: 36294798
DOI: 10.3390/jpm12101659 -
Postgraduate Medicine Apr 1984
Topics: Age Factors; Eye Diseases; Hemorrhage; Humans; Middle Aged; Vitreous Body
PubMed: 6709536
DOI: 10.1080/00325481.1984.11697989 -
Ophthalmology Apr 2021
Topics: Eye Diseases; Female; Fluorescein Angiography; Humans; Iatrogenic Disease; Laser Therapy; Lasers, Solid-State; Middle Aged; Retinal Hemorrhage; Retinal Vein Occlusion; Tomography, Optical Coherence; Ultrasonography; Vitrectomy; Vitreous Body; Vitreous Hemorrhage
PubMed: 33745529
DOI: 10.1016/j.ophtha.2020.10.026 -
Journal Francais D'ophtalmologie May 2004To clarify vitrectomy indications in the treatment of vitreous floaters.
PURPOSE
To clarify vitrectomy indications in the treatment of vitreous floaters.
METHODS
This is a retrospective study of four patients, four eyes (age, 42-65 years), who underwent vitrectomy for the treatment of vitreous floaters. Two patients had a total posterior vitreous detachment. All patients were required to think about the intervention for several months before consenting.
RESULTS
Preoperative visual acuity ranged from 20/40 to 30/30 and after the operation it ranged from 20/40 to 10/10. Minimum follow-up was 1 year. Visual acuity did not decrease after treatment in any patients. All patients expressed satisfaction with their postoperative visual function.
DISCUSSION-CONCLUSION
Visual acuity measures do not always accurately reflect patients' visual discomfort. Vitrectomy has been known for many years. It can be proposed as a last resort after thorough retina examination, after patients have received adequate information and they are psychologically ready for the procedure.
Topics: Adult; Aged; Female; Humans; Male; Middle Aged; Retrospective Studies; Visual Acuity; Vitrectomy; Vitreous Detachment
PubMed: 15179305
DOI: 10.1016/s0181-5512(04)96169-4 -
Ophthalmology. Retina Sep 2018Vitreous floaters can lower visual acuity (VA) and degrade contrast sensitivity function (CSF). Limited vitrectomy improves VA and normalizes CSF, but long-term results...
PURPOSE
Vitreous floaters can lower visual acuity (VA) and degrade contrast sensitivity function (CSF). Limited vitrectomy improves VA and normalizes CSF, but long-term results in a large series with objective quantitative outcome measures are lacking.
DESIGN
Case series.
PARTICIPANTS
One hundred ninety-five eyes of 145 patients (87 men, age = 57.6 ± 4.3 years; 58 women, age = 61.5 ± 12.0 years) reporting bothersome vitreous floaters were compared to 70 age-matched controls. Posterior vitreous detachment (PVD) alone was the cause in 96/195 (49.2%), myopic vitreopathy alone was the cause in 30/195 (15.4%), PVD with myopic vitreopathy was the cause in 56/195 (28.7%), and asteroid hyalosis was the cause in 13/195 eyes (6.7%).
METHODS
Limited vitrectomy with 25-gauge instruments was performed without surgical PVD induction, preserving 3 to 4 mm of retrolental vitreous in phakic eyes. Follow-up averaged 32.6 ± 23.5 months (range, 3-115 months), with 2 years or more in 144 eyes, 3 years or more in 69 eyes, 4 years or more in 51 eyes, and 5 years or more in 24 eyes.
MAIN OUTCOME MEASURES
Visual acuity, 39-item National Eye Institute Visual Function Questionnaire (VFQ) results, CSF (Weber index), and quantitative ultrasonography results.
RESULTS
After surgery, vitreous echodensity decreased by 94.1% (P < 0.0001) and VFQ results improved by 19.3% (P < 0.0001). Preoperative VA was 0.68 ± 0.21, improving to 0.77 ± 0.19 after surgery (P < 0.0001). Preoperative CSF was degraded by 91.3% compared with controls (P < 0.0001), normalizing at 1, 3, 6, 12, 24, 36, and 48 months after surgery (P < 0.00005 for each). There were no cases of endophthalmitis. There were 3 retinal tears and 3 retinal detachments that underwent successful repair. Clinically significant vitreous hemorrhage developed in 2 patients, clearing spontaneously. Two macular puckers and 4 recurrent floaters from new PVD were cured by re-operation. Cataract surgery occurred in 21 of 124 patients (16.9%; mean age, 64 ± 7 years; none younger than 53 years), an average of 13.1 ± 6.8 months after vitrectomy.
CONCLUSIONS
Limited vitrectomy for Vision Degrading Vitreopathy decreases vitreous echodensity, improves patient well-being, improves VA, and normalizes CSF. The long-term efficacy and safety profiles suggest this may be a safe and effective treatment for clinically significant vitreous floaters, warranting a prospective randomized trial.
PubMed: 31047219
DOI: 10.1016/j.oret.2018.03.011 -
Graefe's Archive For Clinical and... May 2024We investigated personality traits and symptoms of anxiety and depression in patients with primary vitreous floaters.
PURPOSE
We investigated personality traits and symptoms of anxiety and depression in patients with primary vitreous floaters.
METHODS
A U.K. sample of adult patients (> 18 years old) with vitreous floaters of a minimum of three months severe enough to seek a consultation was assessed for personality traits (The Big Five Inventory (BFI)), symptoms of depression (Patient Health Questionnaire-9), and symptoms of anxiety (Generalized Anxiety Disorder Questionnaire-7).
RESULTS
149 patients participated in the study. Compared to the general population, our sample had a significantly increased score in the domain of BFI-neuroticism (3.27 vs 2.97, ρ < 0.0001, d = 0.38) and reduced score in the domain of extraversion (2.97 vs 3.24, ρ < 0.0001, d = 0.33). Female patients scored significantly higher than male patients on BFI-neuroticism (ρ = 0.01), and on BFI-agreeableness (ρ = 0.01). Age was positively correlated with BFI-Conscientiousness (r = 0.19, ρ = 0.02) and with BFI-Agreeableness (r = 0.20, ρ = 0.01). 36% of our sample had moderate to severe symptoms of depression, and 43% had moderate to severe symptoms of anxiety.
CONCLUSIONS
Our study highlights the underlying psychological traits of patients with severe vitreous floaters and particular mental health needs that deserve further consideration by ophthalmological and vision science clinicians.
PubMed: 38700589
DOI: 10.1007/s00417-024-06477-y