RECURRENT FLOATERS AFTER LIMITED VITRECTOMY FOR VISION DEGRADING MYODESOPSIA
RECURRENT FLOATERS AFTER LIMITED VITRECTOMY FOR VISION DEGRADING MYODESOPSIA
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DOI：
10.1097/iae.0000000000003781
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发表时间：
2023-07-01
影响因子：
3.3
通讯作者：
Sebag, J.
中科院分区：
文献类型：
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作者：
Boneva, Stefaniya K.;Nguyen, Justin H.;Sebag, J.
目的：有限的玻璃体切除术可改善视力，但术后飞蚊症复发的发生率尚不清楚。我们研究了使用超声检查和对比敏感度（CS）测试，以表征这个亚组，并确定在复发的飞蚊症的风险患者的临床资料的患者复发floaters.Methods：共286眼（203例，60.6和PLUSMN; 12.9年）进行有限的玻璃体切除术的视力退化myodesopsia进行了回顾性研究。进行了无缝线25 G玻璃体切除术，未故意进行玻璃体后脱离（PVD）诱导手术。CS（弗赖堡敏锐度对比试验：韦伯指数，%W）和玻璃体回声密度（定量超声检查）进行了前瞻性评估。14/99只眼（14.1%）发生复发性中央漂浮物，无完全术前PVD（平均随访时间= 39个月，85只眼无复发性漂浮物，平均随访时间= 31个月）。超声检查发现新发PVD在所有14例（100%）复发病例。年轻人（小于52岁; 71.4%），近视（≥-3D; 85.7%），有晶状体眼（100%）男性（92.9%）占主导地位。11例患者选择再次手术，5/11例（45.5%）术前有部分PVD。在研究开始时，CS退化（3.55和PLUSMN; 1.79%W），但术后改善了45.6%（1.93和PLUSMN; 0.86%W，P = 0.033），而玻璃体回声密度降低了86.6%（P = 0.016）。在选择再次手术的患者中，术后新发PVD使CS再次退化49.4%（3.28和PLUSMN; 0.96%W; P = 0.009）。再次玻璃体切除术后CS恢复至2.00± 0.74%W（P = 0.018）。结论：限制性玻璃体切除术治疗视力下降的肌盲症后再次发生飞蚊症是由新发PVD引起的，年轻、男性、近视和有晶状体眼是其危险因素。在这些选择的患者中，应考虑在初次手术时诱导手术PVD，以减轻复发性飞蚊症。
Purpose:Limited vitrectomy improves vision degrading myodesopsia, but the incidence of recurrent floaters postoperatively is not known. We studied patients with recurrent central floaters using ultrasonography and contrast sensitivity (CS) testing to characterize this subgroup and identify the clinical profile of patients at risk of recurrent floaters.Methods:A total of 286 eyes (203 patients, 60.6 & PLUSMN; 12.9 years) undergoing limited vitrectomy for vision degrading myodesopsia were studied retrospectively. Sutureless 25G vitrectomy was performed without intentional surgical posterior vitreous detachment (PVD) induction. CS (Freiburg Acuity Contrast test: Weber index, %W) and vitreous echodensity (quantitative ultrasonography) were assessed prospectively.Results:No eyes (0/179) with preoperative PVD experienced new floaters. Recurrent central floaters occurred in 14/99 eyes (14.1%) without complete preoperative PVD (mean follow-up = 39 months vs. 31 months in 85 eyes without recurrent floaters). Ultrasonography identified new-onset PVD in all 14 (100%) recurrent cases. Young (younger than 52 years; 71.4%), myopic (& GE;-3D; 85.7%), phakic (100%) men (92.9%) predominated. Reoperation was elected by 11 patients, who had partial PVD preoperatively in 5/11 (45.5%). At study entry, CS was degraded (3.55 & PLUSMN; 1.79 %W) but improved postoperatively by 45.6% (1.93 & PLUSMN; 0.86 %W, P = 0.033), while vitreous echodensity reduced by 86.6% (P = 0.016). New-onset PVD postoperatively degraded CS anew, by 49.4% (3.28 & PLUSMN; 0.96 %W; P = 0.009) in patients electing reoperation. Repeat vitrectomy normalized CS to 2.00 & PLUSMN; 0.74%W (P = 0.018).Conclusion:Recurrent floaters after limited vitrectomy for vision degrading myodesopsia are caused by new-onset PVD, with younger age, male sex, myopia, and phakic status as risk factors. Inducing surgical PVD at the primary operation should be considered in these select patients to mitigate recurrent floaters.