Vitreoretinal surgery outcomes

Purpose. To evaluate the impact of vitreoretinal surgery for epiretinal membrane (ERM), rhegmatogenous retinal detachment (RRD), complex retinal detachment (CRD), and proliferative vitreoretinopathy (PVR) on visual function. Methods. Clinical records of all patients who underwent vitreoretinal surgery by a single surgeon at the Bascom Palmer Eye Institute between January 1993 and December 1994 were reviewed. Visual data were analysed in terms of logMAR and percent visual impairment, using the American Medical Association (AMA) Guidelines for Disability. Results. Data was collected for 182 patients with the following diagnoses: ERM (65), RRD (70), CRD (35), and PVR (12). The mean length of follow-up was 11 months (range 3-34). The change in mean logMAR score in the operated eye for the various diagnostic groups ranged from 0.3 for patients with ERM to 0.5 for patients with PVR. For all patients, the percent AMA visual disability decreased from 75% to 55% (p<0.001). The decrease in percent visual disability differed by diagnostic group, ranging from 5% for patients with PVR to 28% for patients with ERM. Conclusions. Although the change in logMAR with surgery was comparable for all diagnostic groups studied, there was a greater decrease in percent visual disability for patients with ERM or RRD than for patients with CRD or PVR. AMA Guidelines for Disability may be more sensitive to changes in vision at better levels of visual acuity than at more severe levels of visual impairment.