Efficacy of pars plana vitrectomy for symptomatic vitreous floaters associated with Fuchs heterochromic iridocyclitis

BACKGROUND: Symptomatic vitreous floaters can significantly impair visual function and quality of life. While pars plana vitrectomy (PPV) has been shown to be effective for vitreous opacifications, data regarding its outcomes in patients with Fuchs heterochromic uveitis (FHU) remain limited. METHODS: This retrospective study included 17 eyes of 17 pseudophakic patients with Fuchs heterochromic uveitis who underwent pars plana vitrectomy for visually significant vitreous opacification and were followed for a minimum of 3 months postoperatively. Preoperative and postoperative best-corrected visual acuity (BCVA), vitreous haze graded according to the Standardization of Uveitis Nomenclature (SUN) classification, intraocular pressure (IOP), and macular optical coherence tomography (OCT) findings were evaluated. BCVA values were converted to logarithm of the minimum angle of resolution (logMAR) for statistical analysis. Changes in visual and anatomical outcomes were analyzed, and the association between preoperative vitreous haze grade and postoperative visual improvement was assessed. RESULTS: The mean duration of symptomatic vitreous floaters was 15.5 ± 6.2 months. Mean BCVA improved significantly from 0.57 ± 0.33 logMAR preoperatively to 0.18 ± 0.21 logMAR at the final follow-up (p < 0.001). The mean vitreous haze grade decreased significantly from 1.88 ± 0.78 to 0.12 ± 0.49 postoperatively (p < 0.001). A moderate positive correlation was observed between preoperative vitreous haze grade and postoperative visual improvement (Spearman’s ρ = 0.49, p = 0.044). Mean IOP did not differ significantly between preoperative and postoperative periods. One patient (5.8%) developed postoperative retinal detachment. No cases of cystoid macular edema or secondary epiretinal membrane formation were observed during follow-up. CONCLUSIONS: Pars plana vitrectomy is an effective treatment option for symptomatic vitreous floaters associated with Fuchs heterochromic uveitis, providing significant visual improvement with an acceptable short-term safety profile. Careful patient selection and meticulous surgical technique are essential to optimize outcomes.