Vitrectomy for floaters can be considered despite limited data
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CHICAGO — Vitrectomy for floaters can be considered on a case-by-case basis despite some associated risks, according to an expert at Retina Subspecialty Day at the American Academy of Ophthalmology meeting.
Jayanth S. Sridhar, MD, said floaters are now the third most common diagnosis in patients older than 60 years and are becoming an increasing problem even in younger patients due to increased screen use for work and recreation.
“Why would we consider intervention for floaters, given they are generally not associated with pathology when isolated?” Sridhar asked. “They may cause reduced quality of life, and patients then seek options for treatment.”
This has become more pronounced in the era of multifocal IOLs, which can reduce contrast sensitivity, Sridhar said. The current options for treatment are observation, laser vitreolysis and vitrectomy.
Sridhar said multiple studies have shown that vitrectomy for floaters can improve visual quality and quality of life. The surgery is generally simple, can be done with multiple gauges and has an overall low complication rate.
However, it is not without risks, including cataract, retinal tear and detachment, and endophthalmitis.
“The question becomes, should we do this surgery or not?” Sridhar said. “If we do it, how do we decide when to do it?”
He said the answer is difficult because data on severity of vitreous floaters are currently lacking.
“I think it can be considered on an individual basis, weighing the pros and cons,” Sridhar said. “Data on optimal patient selection and technique is extremely heterogeneous and limited due to study design and sample size. We look forward to more prospective data as we move forward in the future.”
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Sridhar JS. Floater rectomy: The good, the bad and the ugly. Presented at: American Academy of Ophthalmology meeting; Sept. 30-Oct. 3, 2022; Chicago.
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