The long-term recovery of vision in pseudophakic macula-off rhegmatogenous retinal detachments.

Abstract

Purpose: To assess the long-term visual recovery in uncomplicated macula-off pseudophakic rhegmatogenous retinal detachment (PRRD) treated with pars plana vitrectomy (PPV) and gas tamponade in the absence of other visual co-morbidities. Methods: Single-centre retrospective longitudinal study on eyes with macula-off PRRD successfully treated with PPV between 2011 and 2020 and with at least two follow-ups (FU), first gas-free FU (first-FU) and a final FU, were included. Patients with subsequent ocular surgery or comorbidities affecting BCVA were excluded. The duration between operation date and final-FU was calculated (total days FU [TD]) and split into TD-quintiles: 1:≤57, 2: >57 and ≤77, 3:>77 and ≤152, 4:>152 and ≤508 and 5:>508 days. Multivariable regression was performed with logMAR gain between first and final-FU as the dependent variable. Results: In 209 eyes, we report association with increase of logMAR gain between first and final-FU, with reducing clock-hours of PRRD (p=0.041) and relative to the TD-quintile 1. Mean (standard deviation) LogMAR gain between first and final follow-up was 0.02 (0.07) in the first quintile, increasing to 0.14 (0.13) (p<0.001) by fifth quintile on multivariable regression. For patients not achieving 0.30 logMAR at first-FU, this was attained at final-FU with a sensitivity of 51.9% and specificity of 95.5% at a cut off ≤0.58 logMAR at first-FU (AUC 0.756 [95%CI 0.664 to 0.848], p<0.001) Conclusions: We report a significant time-dependent visual improvement after uncomplicated PPV with gas tamponade for macula-off PRRD without visual confounders, and provide important quantitative data for counselling patients with macula-off repair.