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

Purpose: 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 (=0.0000039 and =0.001, respectively), and lower rates of non-urgent surgeries, such as for epiretinal membrane and macular hole (=0.000032 and =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 (=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.