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Surgery for primary rhegmatogenous retinal detachment: anatomical and visual outcome

Session Details

Session Title: Vitreoretinal Surgery IV

Session Date/Time: Friday 27/09/2013 | 16:30-18:00

Paper Time: 17:50

Venue: Hall 3 (Level 0)

First Author: K.Krepler AUSTRIA

Co Author(s):    E. Smretschnig   C. Falkner-Radler   S. Binder        

Abstract Details

Purpose:

To evaluate anatomical and functional outcome after surgery for primary rhegmatogenous retinal detachment and assess prognostic factors

Setting:

Department of Ophthalmology, Rudolf Foundation Hospital, Vienna

Methods:

In a prospective cohort study all patients who underwent surgery for primary rhegmatogenous retinal detachment in the year 2012 were included. Main outcome measures were single surgery success rate, final anatomical success rate and best corrected visual acuity (BCVA). Follow up was 6 months. Various preoperative factors, such as duration of symptoms, lens status, number of breaks, extent of detachment, status of the macula, PVR as well as intraoperative factors, such as type of surgery, timing of surgery were assessed and correlated with outcome.

Results:

149 eyes of 145 patients were included (54 female, 91 male), 72 eyes presenting with a Macula-on retinal detachment (48.3%), mean extent of detachment was 4.7 clock hours, a mean of 1.7 breaks could be found preoperatively. 90 patients were phakic (60.4%), 58 pseudophakic and 1 aphakic (39.6%) , PVR grade C was found in 13 patients (8.7%). 132 (88.6%) eyes were treated with primary vitrectomy and 17 eyes (13.4%) with a buckle procedure. 65 patients (43.6%) were operated in an emergency setting on the day of admittance. Single surgery success rate was 88.6% (132 eyes) and final success rate 98.7% (149 eyes). Re-detachment rate was 11.3% (15 eyes) in the vitrectomy group and 11.7% (2 eyes) in the buckle group, detachments occuring at a mean of 5.8 weeks and 0.6 weeks after primary surgery respectively. Mean BCVA improved from 0.3 to 0.5 Snellen and was significantly better in Macula-on versus Macula-off retinal detachments preoperatively (0.54 vs 0.18) and postoperatively (0.6 vs 0.35).

Conclusions:

Although final surgical success rate was high, there is still a chance to improve primary surgical success rate both in vitrectomy and buckle cases. Patients with Makula-on retinal detachment have a better visual prognosis, which makes earlier diagnosis of retinal detachment desirable.

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