Clinical Interventions in Aging (Jun 2021)

Epidemiology of Pars Plana Vitrectomy in the Elderly: A Retrospective 10-Year Survey of 592 Cases

  • Elyashiv S,
  • Fogel Levin M,
  • Zloto O,
  • Neimark E,
  • Najjar R,
  • Moisseiev J,
  • Vidne-Hay O

Journal volume & issue
Vol. Volume 16
pp. 1007 – 1012

Abstract

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Sivan Elyashiv,1,2 Miri Fogel Levin,1,2 Ofira Zloto,1,2 Eli Neimark,3 Riham Najjar,4 Joseph Moisseiev,1,2 Orit Vidne-Hay1,2 1Goldschleger Eye Institute, Sheba Medical Center, Tel Hashomer, Israel; 2Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; 3Ben Gurion University of the Negev, Beer Sheba, Israel; 4The Technion ─ Israel Institute of Technology, Ruth and Bruce Rappaport Faculty of Medicine, Haifa, IsraelCorrespondence: Sivan ElyashivGoldschleger Eye Institute, Sheba Medical Center, Tel-Hashomer, IsraelTel +972 3530 2874Fax +972 3530 2822Email [email protected]: To report the epidemiology of the surgical indications of pars plana vitrectomy in patients aged 75 years or older.Patients and Methods: The medical records of patients who underwent vitrectomy surgery in a single center between 2008 and 2018 were evaluated retrospectively for demographics, medical background, and surgical indications. Data on patients aged 75– 85 were compared to those of patients older than 85 years and those recorded between 2008– 2013 and 2014– 2018.Results: A total of 592 patients were included, of whom 55% were males. The mean±standard deviation age of the cohort at presentation was 80.4± 4.60 years, and the mean visual acuity was 1.3± 0.93 logMAR. The main indications for surgery were retinal detachment (n=117, 19.7%), epiretinal-membrane/vitreomacular traction (n=140, 23.6%), dropped intraocular lens/retained lens (n=89, 15%), macular hole (n=64, 11%), submacular hemorrhage (n=40, 6.7%), diagnostic vitrectomy (n=37, 6.2%), non-diabetic vitreous hemorrhage (n=30, 5.1%), and diabetic vitreous hemorrhage and other diabetic complications (n=33, 5.6%). Patients aged 85 years and older had higher rates of urgent surgeries (65%), such as for submacular hemorrhage and trauma (p=0.0000039 and p=0.001, respectively), and lower rates of non-urgent surgeries, such as for epiretinal membrane and macular hole (p=0.000032 and p=0.02, respectively), compared to patients aged 75– 84 years. Additionally, the surgical rate for submacular hemorrhage decreased during 2008– 2014 compared to 2014– 2018 (p=0.000014).Conclusion: Understanding the unique distribution of indications for vitrectomy among elderly patients is essential for appropriate management and treatment. Urgent cases represent 65% of the surgeries performed in the older population.Keywords: aged, epidemiology, pars plana vitrectomy

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