Vitrectomy in patients 85 years of age and older: surgical outcomes and visual prognosis

Roi Anteby,1 Aya Barzelay,1,2 Adiel Barak1,2 1Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; 2Department of Ophthalmology, Tel Aviv-Sourasky Medical Center, Tel Aviv, Israel Purpose: To evaluate visual and surgical outcomes in very elderly patients (above 85 years of...

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Autores principales:	Anteby R, Barzelay A, Barak A
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2018
Materias:	PPV Visual acuity Age related Macular Degeneration Retinal Detachment Geriatrics RC952-954.6
Acceso en línea:	https://doaj.org/article/9e1402421ce4463da9c4602fb061d93a
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spelling	oai:doaj.org-article:9e1402421ce4463da9c4602fb061d93a2021-12-02T00:53:25ZVitrectomy in patients 85 years of age and older: surgical outcomes and visual prognosis1178-1998https://doaj.org/article/9e1402421ce4463da9c4602fb061d93a2018-02-01T00:00:00Zhttps://www.dovepress.com/vitrectomy-in-patients-85-years-of-age-and-older-surgical-outcomes-and-peer-reviewed-article-CIAhttps://doaj.org/toc/1178-1998Roi Anteby,1 Aya Barzelay,1,2 Adiel Barak1,2 1Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; 2Department of Ophthalmology, Tel Aviv-Sourasky Medical Center, Tel Aviv, Israel Purpose: To evaluate visual and surgical outcomes in very elderly patients (above 85 years of age) undergoing pars plana vitrectomy (PPV). Patients and methods: A single-center, retrospective study was carried out on the medical records of 82 patients aged 85 years and older who had undergone PPV from 2006 to 2013. Patients ranged in age from 86 to 99 years, with a mean age of 88.9 years (±2.88). Visual results and intraoperative and postoperative complications were the main outcome measures. Visual improvement/worsening was defined as at least ±0.1 logMAR change. Results: Mean follow-up was 7.25 months (±5.35), with a range of 1–28 months. General anesthesia was used in 63% of the operations. The most common indication was retinal detachment (27%). The ocular condition necessitating PPV was secondary to trauma (most commonly after a fall) in 10 eyes (12%). Mean visual acuity (VA) improved from 1/58 preoperatively to 1/29 at the final evaluation (p=0.014). Mean improvement in VA in eyes of patients with the comorbidity of age-related macular degeneration (n=34) was 41% lower compared to eyes of patients without the disease (n=48, p=0.013). In the subgroup of patients operated on for retinal detachment, 45.4% did not reach primary anatomic success and 45.4% needed additional retina-affecting surgery. One or more major ocular complications were reported in 24 eyes (29%), while 19 eyes (23%) had minor ocular complications. Conclusion: Improved VA was documented in more than half of the older adults aged 85–99 undergoing vitrectomy. Despite the rate of complications in the very elderly, the possibility of optimizing visual function may positively affect quality of life in this subgroup. Keywords: PPV, visual acuity, age-related macular degeneration, retinal detachmentAnteby RBarzelay ABarak ADove Medical PressarticlePPVVisual acuityAge related Macular DegenerationRetinal DetachmentGeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 13, Pp 243-249 (2018)
institution	DOAJ
collection	DOAJ
language	EN
topic	PPV Visual acuity Age related Macular Degeneration Retinal Detachment Geriatrics RC952-954.6
spellingShingle	PPV Visual acuity Age related Macular Degeneration Retinal Detachment Geriatrics RC952-954.6 Anteby R Barzelay A Barak A Vitrectomy in patients 85 years of age and older: surgical outcomes and visual prognosis
description	Roi Anteby,1 Aya Barzelay,1,2 Adiel Barak1,2 1Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; 2Department of Ophthalmology, Tel Aviv-Sourasky Medical Center, Tel Aviv, Israel Purpose: To evaluate visual and surgical outcomes in very elderly patients (above 85 years of age) undergoing pars plana vitrectomy (PPV). Patients and methods: A single-center, retrospective study was carried out on the medical records of 82 patients aged 85 years and older who had undergone PPV from 2006 to 2013. Patients ranged in age from 86 to 99 years, with a mean age of 88.9 years (±2.88). Visual results and intraoperative and postoperative complications were the main outcome measures. Visual improvement/worsening was defined as at least ±0.1 logMAR change. Results: Mean follow-up was 7.25 months (±5.35), with a range of 1–28 months. General anesthesia was used in 63% of the operations. The most common indication was retinal detachment (27%). The ocular condition necessitating PPV was secondary to trauma (most commonly after a fall) in 10 eyes (12%). Mean visual acuity (VA) improved from 1/58 preoperatively to 1/29 at the final evaluation (p=0.014). Mean improvement in VA in eyes of patients with the comorbidity of age-related macular degeneration (n=34) was 41% lower compared to eyes of patients without the disease (n=48, p=0.013). In the subgroup of patients operated on for retinal detachment, 45.4% did not reach primary anatomic success and 45.4% needed additional retina-affecting surgery. One or more major ocular complications were reported in 24 eyes (29%), while 19 eyes (23%) had minor ocular complications. Conclusion: Improved VA was documented in more than half of the older adults aged 85–99 undergoing vitrectomy. Despite the rate of complications in the very elderly, the possibility of optimizing visual function may positively affect quality of life in this subgroup. Keywords: PPV, visual acuity, age-related macular degeneration, retinal detachment
format	article
author	Anteby R Barzelay A Barak A
author_facet	Anteby R Barzelay A Barak A
author_sort	Anteby R
title	Vitrectomy in patients 85 years of age and older: surgical outcomes and visual prognosis
title_short	Vitrectomy in patients 85 years of age and older: surgical outcomes and visual prognosis
title_full	Vitrectomy in patients 85 years of age and older: surgical outcomes and visual prognosis
title_fullStr	Vitrectomy in patients 85 years of age and older: surgical outcomes and visual prognosis
title_full_unstemmed	Vitrectomy in patients 85 years of age and older: surgical outcomes and visual prognosis
title_sort	vitrectomy in patients 85 years of age and older: surgical outcomes and visual prognosis
publisher	Dove Medical Press
publishDate	2018
url	https://doaj.org/article/9e1402421ce4463da9c4602fb061d93a
work_keys_str_mv	AT antebyr vitrectomyinpatients85yearsofageandoldersurgicaloutcomesandvisualprognosis AT barzelaya vitrectomyinpatients85yearsofageandoldersurgicaloutcomesandvisualprognosis AT baraka vitrectomyinpatients85yearsofageandoldersurgicaloutcomesandvisualprognosis
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Vitrectomy in patients 85 years of age and older: surgical outcomes and visual prognosis

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