This is a retrospective review of patients operated on by two of the authors (LK and TJW) at the Jules-Gonin Eye Hospital between January 2015 and December 2016.Ĭases of RD with confirmed macular involvement for which postoperative follow-up data were available. In the present study, we have evaluated the characteristics of patients presenting complete short-term recovery of visual acuity (0 LogMAR units) after vitrectomy for macula-off RD. These data have allowed new insights into understanding visual recovery after successful macula-off RD surgery and the potential predictive factors associated with functional recovery. įurthermore, in recent years, optical coherence tomography (OCT) has allowed objective and quantitative measurements of RRD height and a more precise evaluation of the architectural changes of the detached retina.
RECOVERY FROM RETINA DETACHMENT SURGERY FORUM FULL
However, in recent years, emerging data from experimental research studies, but also from few clinical studies, are suggesting that a more timely intervention may be required in macula-off RRD than previously believed in order to achieve the healing of cellular damage coupled with full functional recovery. Many vitreoretinal departments apply that timeframe for surgery of macula-off RDs.
It has been suggested that a macula-off RD should be operated within the 1st week after its development and that a more urgent surgical repair does not affect visual outcome and is therefore not necessary. Many preoperative factors have been reported to be affecting the recovery of vision following reattachment of a macula-off RRD including age of the patient, height of the macular detachment (MD), duration of the MD and the best-corrected visual acuity (BCVA). Nevertheless, functional outcomes after surgery are variable and unpredictable for these cases and patients present more often with incomplete recovery of their visual acuity. Surgical management of macula-off rhegmatogenous retinal detachment (RRD) has been associated with a high rate of anatomical success in recent years. Additionally, preservation of the foveal depression of the detached retina appeared to be a common characteristic among patients demonstrating complete visual recovery. In our study, patients had significantly better chances of complete visual acuity recovery when operated within 3 days of MD in comparison to more delayed surgery. In 63% of the 40 cases in whom an optical coherence tomography (OCT) of the fovea could be interpreted, OCT image showed a retained foveal depression of the detached retina, whereas only 35% of the 46 control eyes with adequate OCT imaging showed a retained foveal depression ( p = 0.01). In comparison only 18% of the group of patients with partial recovery of visual acuity after vitrectomy for macula-off RD had been operated within 3 days of MD ( p < 0.0001). The majority of the patients (91%) had up to 3-day duration of macular detachment (MD) before surgery. Forty-three of the patients (58%) had preoperative BCVA equivalent of count fingers or less. Median pre-op best-corrected visual acuity (BCVA) was 2 LogMAR (interquartile range: 1.22). Median follow-up was 6 months (interquartile range: 3). Mean age was 65 years (standard deviation: 12). Seventy-four patients, 46 males (62%) and 28 females (38%), were included. A control group of 83 patients with comparable baseline characteristics but partial recovery of visual acuity after vitrectomy for macula-off RD was used for statistical comparison analysis. The study included patients with visual acuity recovery of 0 LogMAR. Retrospective review of patients operated for macula-off RD at Jules-Gonin Eye Hospital between January 2015 and December 2016. The purpose of this study is to investigate potential factors predicting complete recovery of visual acuity following surgery for macula off retinal detachment (RD).
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