Clinical Outcomes of Surgical Synechiolysis in Patients with Posterior Synechiae after Vitrectomy

Abstract

Purpose: Posterior synechiae can occur as a complication following vitrectomy. This study analyzes the changes in patients before and after surgical synechiolysis.Methods: A retrospective chart review was conducted of 34 patients who underwent surgical synechiolysis after cataract surgery and vitrectomy from January 2020 to February 2023 at a single institution, along with a control group of 30 patients. Surgery was indicated for patients experiencing dysphotopsia due to posterior synechiae, specifically those with iridocapsular adhesions exceeding one quadrant. Visual acuity and spherical equivalent were measured before and after surgery. The degree of dysphotopsia was assessed using the Leiden Visual Sensitivity Scale (L-VISS) which includes questions on sensitivity to light and patterns and a comparative analysis with the control group was conducted.Results: An increase in best-corrected visual acuity was observed in 5 of 34 eyes (14.7%) which was not statistically significantly different from the control (<i>p</i> = 0.550). Hyphema occurred in 24 eyes (70.6%), and iridodialysis in 1 eye (2.9%), during surgery. No cases of persistent intraocular pressure elevation or recurrence of synechiae were reported after surgery. No significant difference in spherical equivalent (<i>p</i> = 0.376) was observed pre- versus post-surgery, but there was a statistically significant improvement in the L-VISS score at 6 months after surgery (11.88 ± 3.06) compared to before surgery (14.88 ± 3.44, <i>p</i> < 0.001).Conclusions: Surgical synechiolysis is associated with a low risk of complications after surgery. Although no significant improvement in visual acuity was noted, the surgery effectively improved dysphotopsia in patients.