title: Visual outcome in 2000 eyes following microscopic transsphenoidal surgery for pituitary adenomas: Protracted blindness should not be a deterrent.
abstract: OBJECTIVE
  To study the visual outcome after surgery for pituitary adenomas with visual deficits.
  
  
  METHODS
  All patients with pituitary adenoma, who presented from 2003-2014 in a tertiary care institute, were included in the study. Surgical outcome was measured in terms of difference in visual acuity, visual fields and optic fundus parameters documented before surgery, immediate post-operatively and at the third, and twelfth months following surgery.
  
  
  RESULTS
  At the initial presentation, visual involvement was seen in 87.2% patients. One year after surgery, 93.2% patients having abnormal vision had improvement in visual acuity and visual fields; whereas visual parameters were static in 5.2%. Visual deterioration occurred only in 1.3% patients. Moreover, five-percent of those who did not even have perception of light at presentation experienced significant improvement in vision after surgery. The shorter the duration of visual symptoms, the more was the percentage of patients having faster recovery in the early postoperative period.
  
  
  CONCLUSIONS
  Post-operative visual outcome was directly proportional to the pre-operative visual acuity. Though the visual outcome was good in the long run irrespective of the duration of symptoms, the speed of recovery was proportional to the duration of visual deficits. However, presence of long-standing visual symptoms should not deter us to subject the patient to surgery. Even patients who are completely visually impaired for years should be subjected to surgery as early as feasible.
authors.affiliation: Department of Endocrinology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
authors.forename: Pinaki
authors.initials: P
authors.lastname: Dutta
authors.affiliation: Department of Neurosurgery, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
authors.forename: Tenzin
authors.initials: T
authors.lastname: Gyurmey
authors.affiliation: Department of Ophthalmology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
authors.forename: Reema
authors.initials: R
authors.lastname: Bansal
authors.affiliation: Department of Neurosurgery, Fortis Hospital, Mohali, Punjab, India.
authors.forename: Ashis
authors.initials: A
authors.lastname: Pathak
authors.affiliation: Department of Neurosurgery, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
authors.forename: Sivashanmugam
authors.initials: S
authors.lastname: Dhandapani
authors.affiliation: Department of Neurosurgery, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
authors.forename: Ashutosh
authors.initials: A
authors.lastname: Rai
authors.affiliation: Department of Neurosurgery, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
authors.forename: Anil
authors.initials: A
authors.lastname: Bhansali
authors.affiliation: Department of Neurosurgery, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
authors.forename: Kanchan Kumar
authors.initials: KK
authors.lastname: Mukherjee
mesh_terms: D000236:Adenoma / Q000601:surgery*; D001766:Blindness / Q000209:etiology*; D019299:Decompression, Surgical; D006801:Humans; D010911:Pituitary Neoplasms / Q000601:surgery*; D011183:Postoperative Complications; D014792:Visual Acuity; D014794:Visual Fields