Neurosurgical Approaches and Visual Outcomes in Pituitary Adenoma Surgery

Visual Outcomes in Pituitary Adenoma Surgery

  • Pir Tufail Ahmad Hayatabad Medical Complex, Peshawar
  • Mohammad Nasir MTI-Hayatabad Medical Complex Peshawar
  • Ihsanullah MTI-Lady Reading Hospital Peshawar
  • Fayyaz Ahmad MTI-Hayatabad Medical Complex Peshawar
  • Rizwan Ali MTI-Mardan Medical Complex Mardan
Keywords: Pituitary adenoma, transsphenoidal surgery, visual outcomes, optic chiasm, neurosurgery

Abstract

Objective: To evaluate the visual outcomes of patients undergoing pituitary adenoma surgery using transsphenoidal and transcranial approaches at Hayatabad Medical Complex, Peshawar. The study focused on identifying factors influencing visual recovery and comparing the effectiveness of both surgical methods.

Methodology: A retrospective study was conducted from January 2023 to December 2023, including 100 patients, divided into transsphenoidal (n=50) and transcranial (n=50) groups. Patient demographics, tumour characteristics, and visual outcomes were analysed. Statistical analysis included chi-square tests, independent t-tests, and logistic regression, with a significance level of p<0.05.

Results: The mean age of patients was 45.2 ± 13.4 years (transsphenoidal) and 47.6 ± 14.3 years (transcranial) (p=0.421). Preoperative visual acuity was 20/200 ± 70 in the transsphenoidal group and 20/180 ± 65 in the transcranial group (p=0.325). Postoperatively, visual acuity improved to 20/50 ± 30 (transsphenoidal) and 20/100 ± 55 (transcranial) (p=0.005). Optic chiasm involvement was significantly higher in the transcranial group (80% vs. 10%, p<0.001). Logistic regression analysis identified the surgical approach as a significant predictor of visual improvement (OR: 2.13, 95% CI: 1.10 - 4.12, p=0.028).

Conclusion: Transsphenoidal surgery resulted in better visual outcomes than transcranial surgery. Tumour size and optic chiasm involvement significantly influenced recovery. Future research should focus on long-term outcomes and patient selection criteria.

Published
2025-06-30
How to Cite
Pir Tufail Ahmad, Mohammad Nasir, Ihsanullah, Fayyaz Ahmad, & Rizwan Ali. (2025). Neurosurgical Approaches and Visual Outcomes in Pituitary Adenoma Surgery: Visual Outcomes in Pituitary Adenoma Surgery. Annals of Punjab Medical College, 19(2). https://doi.org/10.29054/apmc/2025.1738