Anatomical and functional outcomes of surgery of rhegmatogenous retinal detachment

Abstract

Introduction: Rhegmatogenous retinal detachment (RRD) is a potentially blinding condition.Objective: To evaluate the anatomical and functional outcome of surgery of RRD. Materials and methods:A prospective study of interventional case series was designed including 50 consecutive patients with RRD in a tertiary level eye center in Kathmandu. The patients underwent scleral buckling (SB) or pars plana vitrectomy (PPV) according to the proliferative vitreo-retinopathy (PVR) changes. All the patients had at least 3 months of follow-up. The anatomical and physiological outcome measures were primary retinal reattachment and improvement in visual acuity respectively. The surgery was considered successful when there was attachment of retina after the first surgery. Results:The mean age of these patients at the time of presentation was 46.24 ± 19.82 years. Of 50, sixty-six percent of the patients underwent SB and 34 % underwent PPV. Primary surgical success rate was 88 %. While comparing the initial best corrected visual acuity (BCVA) with the final, 72% had an improvement, 12 % unchanged and 16 % had a deteriorated visual acuity. Conclusion:The visual acuity improves and the anatomical success rate is high in the majority of the patients after surgery for rhegmatogenous retinal detachment.

CHARACTERISTICS OF RETINAL DETACHMENT PATIENTS WITH PROLIFERATIVE VITREORETINOPATHY AT Dr. SOETOMO GENERAL ACADEMIC HOSPITAL

“…What we found in this study is younger than previous studies. [3][4][10][11][12][13]15,17,[19][20][21] However, the results in this study are similar with other studies. 14,[22][23][24][25] Age factors are considered to have an effect on the incidence of retinal detachment.…”

“…The results of this study are similiar with several previous studies. 3,10,15,21 According to Tseng et al, 2004, 4 macula off showed severe PVR conditions. According to Khanzada et al, 2014, 31 macular conditions will influence the visual prognosis of post-RRD surgery outcomes, where the longer macula off, the poorer visual outcome.…”

Seasonal Variation in the Occurrence of Rhegmatogenous Retinal Detachment

“…Timely recognition maximizes the chance of successful repair with improvement in visual acuity. 4,5 The factors associated with the development of RD include retinal breaks, vitreous liquefaction and detachment, traction on the retina, and intraocular fluid currents resulting in movement of liquid vitreous into the subretinal space. 2 The retina is kept attached by the adhesive effect of mucopolysaccharides in the subretinal space, oncotic pressure differences, hydrostatic force related to IOP, and the ability of the retinal pigment epithelium pump to push fluid away from the subretinal space.…”

Loss of Visual Acuity after Successful Surgery for Macula-On Rhegmatogenous Retinal Detachment in a Prospective Multicentre Study

“…Besides adequate anatomical reattachment, other clinical factors have been identified as determinants that prevent a good functional recovery. The status of the macula is the main factor for a successful functional result [ 10 – 12 ]. Even in a successful RD surgery with a clinically normal macular area, the final vision may be subnormal.…”

“…Even in a successful RD surgery with a clinically normal macular area, the final vision may be subnormal. Poor visual acuity (VA), color vision defects, and metamorphopsia have been described in successful postoperative RD macula-on surgeries, suggesting the existence of microstructural retina damage [ 12 ].…”