Transsphenoidal surgery (TSS) represents the gold standard of pituitary adenoma resection, providing a safe and minimal invasive treatment for patients suffering from symptoms of mass effect. The aim of this study is to analyze the postoperative improvement of visual function after adenoma resection and to identify prognostic factors for the postoperative clinical recovery. We performed a retrospective analysis of all consecutive patients treated via a transsphenoidal approach for pituitary adenomas from April 2006 to December 2019 in a high-volume neurosurgical department. Our primary outcome was postoperative visual acuity and visual field impairment; the clinical findings were followed up to 3 months after surgery and correlated with clinical and radiographic findings. In total, 440 surgeries were performed in our department for tumors of the sella region in a time period of 13 years via transsphenoidal approach, and 191 patients included in the analysis. Mean age was 55 years, and 98% were macroadenomas. Mean preoperative visual acuity in patients with preoperative impairment (n = 133) improved significantly from 0.64/0.65 to 0.72/0.75 and 0.76/0.8 (right eye R/left eye L) postoperatively and at 3 months follow-up (p < 0.001). Visual acuity significantly depended on Knosp classification but not Hardy grading. The strongest predictor for visual function recovery was age. Transsphenoidal pituitary tumor resection remains a safe and effective treatment in patients with preoperative visual impairment. It significantly improves visual acuity and field defects after surgery, and recovery continues at the 3 months follow-up examination.

经蝶窦手术 (TSS) 代表垂体腺瘤切除术的金标准，为患有占位效应症状的患者提供安全且微创的治疗方法。本研究的目的是分析腺瘤切除术后视功能的改善情况，并确定影响术后临床恢复的预后因素。我们对 2006 年 4 月至 2019 年 12 月在高容量神经外科通过经蝶入路治疗垂体腺瘤的所有连续患者进行了回顾性分析。我们的主要结果是术后视力和视野损伤；临床发现在手术后进行了长达 3 个月的随访，并与临床和影像学发现相关联。总共，我们科在 13 年的时间里通过蝶骨入路对蝶鞍区肿瘤进行了 440 例手术，其中 191 例患者纳入分析。平均年龄为 55 岁，98% 为大腺瘤。术前损伤患者的平均术前视力（n  = 133) 在术后和 3 个月的随访中从 0.64/0.65 显着改善到 0.72/0.75 和 0.76/0.8（右眼 R/左眼 L）（p  < 0.001）。视力显着取决于 Knosp 分级，而不是 Hardy 分级。视觉功能恢复的最强预测因子是年龄。对于术前视力障碍患者，经蝶窦垂体瘤切除术仍然是一种安全有效的治疗方法。显着改善术后视力和视野缺损，3个月随访检查时恢复继续。