Vitreous opacity vitrectomy safe and effective for removal of "Floaters": Study

USA: Vitreous opacity vitrectomy (VOV) techniques can potentially reduce risk to the minimal in elective vitrectomy performed for any indication, states an article published in Clinical Ophthalmology. All eyes treated with VOV, achieved continuously clear vision and no eye developed clinically significant complications, during the 1-year follow-up.

Cataracts, a Lens opacity developing in the aging eye is reported as the leading cause of blindness and the second cause of moderate and severe vision impairment globally. The "vitreous" gel, present behind the lens also develops opacities that seem to "float" (floaters), appearing as false objects in the field of vision. Some eyes develop many symptomatic vitreous opacities (SOV) that substantially interfere with their daily visual activities which is termed Degenerative Vitreous Syndrome (DVS)

Morris RE, Retina Specialists of Alabama, LLC, USA conducted a study to describe DVS diagnosis and Vitreous Opacity Vitrectomy or VOV technique for removal of DVS vitreous opacities with the least possible surgical risk, similar to that of cataract extraction. It immediately restores continuously clear vision for DVS sufferers, as the eye quickly and permanently replaces the removed DVS gel with clear aqueous fluid.

The authors analyzed a consecutive series of 100 eyes treated for DVS by VOV operations (in 81 patients, average age 66) performed with ultra-high speed, 27-gauge vitrectomy probes, using 27-gauge (G) 7500 cuts per minute (cpm) probes. The mean patient age was 66 years (range 38–83, median 67). All patients who presented with chief complaints related to SOV were scheduled for VOV, after diagnosing no improvement in DVS for at least three months and after adequate counseling. All patients had a minimum of six months follow-up postoperatively, with a mean follow-up of 37 months

Key findings of the analysis,

• All eyes rapidly achieved continuously clear vision, and no eye developed a clinically significant complication during a year of follow-up.

• Three small, existent retinal breaks were discovered before peripheral vitrectomy and one iatrogenic retinal tear was found at VOV completion.

• In the eyes that were not pseudophakic, postoperative nuclear sclerosis progression was successfully managed by subsequent cataract extraction.

The author concluded that the benefits of VOV techniques of promptly, completely, and permanently restoring continuously clear vision, and ensuring retinal integrity by microscopic examination of the peripheral retina under anesthesia, are deemed to outweigh the risks associated with the procedure.

Although VOV is eligible for only certain symptomatic patients, it may be an option in the hands of an experienced surgeon, the author wrote.

Reference:

Morris RE. Vitreous Opacity Vitrectomy (VOV): Safest Possible Removal of "Floaters". Clin Ophthalmol. 2022;16:1653-1663. https://doi.org/10.2147/OPTH.S361557