All patients were operated at the Academic Medical Center Amsterdam, a tertiary academic referral center. All patients gave informed consent for the procedure. Patients often were examined on multiple visits before consideration of surgical intervention to confirm the persistence of the symptoms and to provide detailed information to each patient regarding the potential risks of the procedure. Data were retrieved from an electronic patient file containing selleck structured operation notes and reports of all visits. Operations were performed with the Alcon Accurus or Alcon Constellation machine (Alcon Laboratories, Fort Worth, Texas, USA) and a BIOM wide-angle viewing system (Binocular Indirect Ophthalmol Microscope; Oculus Inc,
Wetzlar, Germany). For the Accurus 25-gauge procedures, ROCK inhibitor infusion
pressure was set at 30 mm Hg, vacuum was set at 500 mm Hg, and cutting rate varied between 1000 and 1500 cuts/minute. For the Constellation 25-gauge procedures, infusion pressure was 25 mm Hg, vacuum was 300 mm Hg, and cutting rate varied between 2500 and 5000 cuts/minute. For all 20-gauge procedures, infusion pressure was set at 20 mm Hg and vacuum was set at 300 mm Hg, with cutting rate varying between 1000 and 2500 cuts/minute. If the posterior hyaloid was attached, a PVD always was induced. Vitreous was removed up to the vitreous base. We did not use visualization aids during the PVD induction. Shaving of the vitreous base was performed only around retinal breaks. An extensive internal search was performed in all cases using visualization with the BIOM system and scleral indentation, and the location of retinal breaks were drawn in
the chart. All peripheral lesions that resembled breaks or areas of traction were treated with external cryotherapy. Parameters next retrieved were patient characteristics, preoperative and postoperative VA, preoperative phakic status, combined phacoemulsification, comorbidity, active PVD induction, intraoperative peripheral retinal breaks or traction areas, application of cryocoagulation, and tamponade type. Statistical analysis was performed using SPSS software for Windows version 16.0 (SPSS Inc, Chicago, Illinois, USA) for chi-square test, Wilcoxon signed-rank test, Mann–Whitney U test, and Kruskal-Wallis analysis. For analysis, VA was converted to logarithm of the minimal angle of resolution (logMAR) values, whereby counting fingers was converted to 1.40 logMAR and hand movements was converted to 2.70 logMAR. A total of 116 eyes from 97 patients were included. All cases had a history of persistent floaters for at least 6 months. Mean follow-up was 10.1 months (range, 3 to 57 months). Mean patient age was 58.7 years (range, 26 to 86 years). Most operations were performed under local anesthesia. General anesthesia was used only in patients who made a specific request. The posterior hyaloid was still attached in 30 (25.9%) cases. In all of these, we actively induced a full PVD.
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