National audit of the outcome of primary surgery for rhegmatogenous retinal detachment. II. Clinical outcomes

Thompson, James T.; Snead, Martin P.; Billington, B M; Barrie, T; Thompson, John R.; Sparrow, J M

doi:10.1038/sj.eye.6700325

Cited by 82 publications

(38 citation statements)

References 11 publications

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“…2,5 In this study there was no difference for different grades of surgeons in terms of primary anatomical success and both groups had similar visual outcomes.…”

mentioning

confidence: 70%

How effective is macula-off retinal detachment surgery. Might good outcome be predicted?

Doyle

Herbert

Bunce

et al. 2006

Eye

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Purpose To determine factors associated with anatomical and functional outcomes of macula-off retinal detachment surgery in a modern vitreoretinal unit. Methods A retrospective casenote review of 185 patients presenting with macula-off retinal detachment was performed. Demographic and ocular characteristics were determined. Logistic regression analysis was used to determine (1) the effect of these factors on visual outcome and (2) their effect on primary and final anatomical success. Results Primary and ultimate anatomical success were achieved in 76 and 84% of cases. Patients with oil in at final follow-up were considered to be anatomical failures. Statistically significant factors predicting primary anatomical success using a multiple variable model were preoperative logMAR visual acuity, preoperative PVR and number of breaks. Preop logMAR visual acuity and duration of macular detachment were the statistically significant factors predicting ultimate success. In all, 44% of patients regained 6/12 Snellen or better with a median improvement of 0.78 logMAR. For prediction of visual outcome (in patients with no ocular comorbidity) only preoperative logMAR visual acuity achieved statistical significance (P ¼ 0.001) at the P ¼ 0.05 level. Conclusion In all, 76% of macula-off detachments may be repaired with one operation and 44% of patients regain at least 6/12 Snellen. The median logMAR acuity increment of 0.78 far exceeds that seen in cataract surgery. Preoperative visual acuity is the most important factor predicting primary and final anatomical success as well as visual outcome. Preoperative PVR, number of breaks and duration of detachment also affect outcomes.

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“…2,5 In this study there was no difference for different grades of surgeons in terms of primary anatomical success and both groups had similar visual outcomes.…”

mentioning

confidence: 70%

How effective is macula-off retinal detachment surgery. Might good outcome be predicted?

Doyle

Herbert

Bunce

et al. 2006

Eye

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“…Today, surgical repair of RRD, using advanced technology, achieves a primary success rate of 90% [3][4][5]. In spite of this, visual acuity of the patients following treatment is still limited [6][7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Upregulation of Semaphorin 3A and the associated biochemical and cellular events in a rat model of retinal detachment

Klebanov

Nitzan

Raz

et al. 2008

Graefes Arch Clin Exp Ophthalmol

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The biochemical and morphological changes suggest that apoptosis as well as axonal regrowth take place following retinal detachment. Collectively, these findings may explain the limited success following repair surgery in terms of visual acuity and physiological function of the retina. Our study may open a new approach for treatment of early phase retinal detachment, as well as improve post-operative care that may, in turn, improve the functional result of the surgery. In addition, further study is required on several other factors that may affect visual acuity, such as size and location of the detached area and the time lapse between detachment and surgery.

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“…With primary anatomical success rates ranging from 81-92% in uncomplicated cases, [1][2][3][4][5][6][7] 65-70% in high-risk eyes, or 75% when no break is found, 2,[8][9][10][11][12] visual recovery is not certain. Even with successful re-attachment of the retina, the visual acuity (VA) may not return to the pre-morbid level.…”

Section: Introductionmentioning

confidence: 99%

Characteristics of rhegmatogenous retinal detachment and their relationship to visual outcome

Williamson

Shunmugam

Rodrigues

et al. 2013

Eye

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Aims To examine pre-operative characteristics of rhegmatogenous retinal detachment (RRD) and their relationship to visual acuity (VA) following surgery. Methods Review of prospectively completed electronic database. Baseline characteristics, retinal drawings and outcomes were analysed. Results In all, 847 eyes from 847 patients with a mean age of 62.2 years, 60% males, and 56% right eyes were studied. Mean follow-up was 9.6 months. Preoperative VA correlated with final VA (r 2 ¼ 0.21, Po0.0001). Median postoperative VA was 6/9 (Logmar 0.18, quartiles ¼ 0.0-0.48) and was significantly related to anatomical success: 70.15% achieved 0.18 or better with fully attached retina and primary success, whereas only 8.33% achieved this when the retina was not fully attached at final follow-up (failure) (Po0.0001). Univariate analysis found multiple variables associated with achieving 0.18 postoperative vision, however, multivariate analysis revealed only primary anatomical success with surgery; absence of proliferative vitreo-retinopathy (PVR), betterpresenting VA and fewer quadrants of detachment were associated with a better visual outcome (r 2 ¼ 0.26, Po0.0001). Patients with a clinically attached fovea achieved better vision than patients with a clinically detached fovea, independent of the visual loss duration. With foveal detachment however, postoperative VA was better in patients with 1-3 days of visual loss compared with 4-6 days (P ¼ 0.013). Conclusions Failure of primary surgery, PVR, extensive RRD and poor-presenting VA are risk factors for poorer visual outcome following surgery for RRD. Fovea off RRD at presentation achieved poorer postoperative VA than fovea attached and visual outcome was poorer when there was a longer duration of visual symptoms.

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National audit of the outcome of primary surgery for rhegmatogenous retinal detachment. II. Clinical outcomes

Cited by 82 publications

References 11 publications

How effective is macula-off retinal detachment surgery. Might good outcome be predicted?

How effective is macula-off retinal detachment surgery. Might good outcome be predicted?

Upregulation of Semaphorin 3A and the associated biochemical and cellular events in a rat model of retinal detachment

Characteristics of rhegmatogenous retinal detachment and their relationship to visual outcome

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