Purpose : Describe the surgical technique of selective vitrectomy (SV) with removal of only core vitreous floaters and opacities (VFO). Present pre-and-post SV anatomical and functional results using a new testing methodology (SK-VFO Test) and two new and different navigated widefield swept-source OCT (SS-OCT) imaging technologies.

Methods : Retrospective study of 19 eyes (14 patients) with symptomatic VFO underwent the SK-VFO Test: logMAR best-corrected visual acuity (BCVA), SK infra-red confocal SLO (SK IRcSLO) (Canon Xephilio OCT-S1, Canon Medical Systems Europe, The Netherlands, Spectralis, Heidelberg Engineering, Germany) , straylight measurements (SM) (HD Analyzer, Keeler, USA), Light Disturbance Analyser (LDA, Binarytarget LDA, Portugal) and C-Quant (Oculus Optikgeräte GmbH, Germany) pre- and post-SV (25-G (n=4) or 27-G (n=15)).
Navigated multiwavelength ultrawidefield imaging with widefield swept-source OCT (SS-OCT) (Silverstone, Optos PLC, Scotland, United Kingdom) was performed pre- and post-SV to assess VFO, vitreoretinal interface (VRI)/posterior vitreous detachment (PVD) status obtaining 200° fundus images and 100 KHz 23 mm long SS-OCT scans with a 2.5mm imaging window. A new widefield SS-OCT technology allowing for 200 KHz 130° field-of-view single-scan 26mm long scans with a 12mm deep imaging window and a navigated imaging technique was also used pre- and post-SV in 4 eyes (DREAM OCT, Intalight, China).

Results : Post-SV, 93.75% of eyes experienced improvement in straylight measurements, 30% reduction in HD-analyser Objective Scattering Index, 58% reduction in LDA (p = 0.02) and 3% reduction in C-Quant log units. Both widefield SS-OCT technologies demonstrated the anatomical features of the pre-SV VFO, VRI/PVD status as well as the post-SV residual vitreous and VRI/PVD status (n=19 (100%)).

Conclusions : Selective Vitrectomy was effective in treating VFO. The SK-VFO Test showed post-SV resolution of VFO symptoms with resolution of VFO in UWF images and SS-OCT scans, improved visual function and improved light scatter results.
Navigated widefield SS-OCT is essential to assess pre- and post-SV VFO and vitreous characteristics. The new 200 KHz 26mm-long scan widefield SS-OCT technology, especially with a 12mm imaging window, allowed for significantly improved visualisation of the VFO, mid and cortical vitreous and VRI/PVD status pre- and post-SV.

This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.