Abstract
Purpose. To identify causes of incomplete visual recovery in patients with anatomically successful retinal detachment surgery. Methods. This was a retrospective study of 61 eyes of 61 patients with at least 12-month follow-up and complete preoperative, intraoperative, and postoperative record. Postoperative visual acuity (VA) more than 0.18 logMAR was considered as incomplete visual recovery. Complete ophthalmic examination and Spectral-Domain OCT (SD-OCT) imaging were performed at last follow-up. Results. Twenty-nine eyes (47.5%) had a postoperative VA < 0.18 logMAR and 32 eyes (52.5%) had a postoperative VA ≥ 0.18 logMAR. Mean follow-up was 32.8 ± 17.3 months. Incomplete visual recovery was strongly correlated with presence of macular pathology (P = 0.002), a detached macula preoperatively (P = 0.02), retinotomy (P = 0.025), and pars plana vitrectomy and use of silicon oil as a tamponade agent (P = 0.009). Also, although there was a strong correlation between ellipsoid zone disruption and incomplete visual recovery, a distinct, more course pathology could be identified in all cases of poor visual recovery related to edema, thickening, or atrophy of the macula. Conclusion. The careful postoperative evaluation of the macula using biomicroscopy and SD-OCT can help in diagnosis of alterations that can be associated with incomplete visual recovery.
Highlights
Advances in vitreoretinal surgical techniques during the last 30 years resulted in high percentages of anatomical success in rhegmatogenous retinal detachment (RRD) repair surgery
Macular abnormalities such as cystoid macular edema (CME), epiretinal membranes (ERM), pigment alterations, or a macular hole can occur after anatomically successful repair and lead to incomplete visual recovery
Duration of macular detachment prior to surgery had not been possible to be accurately estimated for all our patients and it was not included in our data analysis
Summary
Advances in vitreoretinal surgical techniques during the last 30 years resulted in high percentages of anatomical success in rhegmatogenous retinal detachment (RRD) repair surgery. Postoperative macular abnormalities after anatomically successful RRD surgery have been associated with incomplete visual recovery [2,3,4]. Macular abnormalities such as cystoid macular edema (CME), epiretinal membranes (ERM), pigment alterations, or a macular hole can occur after anatomically successful repair and lead to incomplete visual recovery. The presence of subretinal fluid (SRF), not always clinically evident, may be associated with poor visual outcome
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