Vitreous floaters aren’t a serious condition, but they can diminish a patient’s quality of life. They are a nuisance that can range from mildly irritating to persistently annoying. But one thing’s for sure: whether the patient is severely impacted or not, they are likely to ask their eye care provider if they can do anything to help. ODs usually reserve surgical referrals for vision-threatening diseases, but research shows when floaters become debilitating, pars plana vitrectomy can lead to positive outcomes.1
A recent study shows 92% of patients were satisfied with the results of the procedure, and 86.3% reported complete symptom resolution.1 And calling a mere floater “debilitating” isn’t a joke. The research shows physicians frequently underestimate the impact floaters have on patients’ quality of life.2 In one study, patients rated them so severe that they were willing to accept a 7% risk of blindness to solve the problem.3
The study included information on 581 eyes that underwent the procedure from 48 vitreoretinal surgeons across 16 countries. The investigators looked into the patients’ percentage of symptomatic improvement, incidence of retinal tears or detachment and post-vitrectomy cataract surgery, and the factors associated with satisfaction and complications.
The satisfaction was lower in patients with smaller vitreous opacities at presentation. A rather severe complication—iatrogenic retinal breaks—occurred in 5% of eyes. Core vitrectomy and cut rates of >4,000cuts/min were associated with lower risk of retinal breaks than complete vitrectomy and cut rates < 1,500cuts/min. Another 2.4% of eyes developed retinal detachments a median of three months after the procedure and 48.6% developed cataracts at a median of 16 months later.
1. Zeydanli E, Parolini B, Ozdek S, Management of vitreous floaters: an international survey the European VitreoRetinal Society Floaters study report. Eye. April 20, 2020. [Epub ahead of print].
2. Zou H, Liu H, Xu X, Zhang X. The impact of persistent visually disabling vitreous floaters on health status utility values. Qual Life Res. 2013;22:1507-14.
3. Wagle AM, Lim WY, Yap TP, Neelam K, Au Eong KG. Utility values associated with vitreous floaters. Am J Ophthalmol. 2011;152:60–5e1.