Abstract
Objective: To assess impact of duration of macular detachment on visual outcome after scleral buckling for retinal detachment with macula off. Methods: Prospective, descriptive case series was conducted at Ophthalmology Department Dow University of Health Sciences, Civil Hospital Karachi and Al Noor Eye Clinic Karachi from May 2012 to June 2013. Five groups were made according to period of macular detachment. Best corrected Visual acuity (BCVA) was main outcome measure. P value < 0.001 was considered significant. Results: Mean duration of macula off was 17.0±4.0 (SD) days. Mean pre-operative VA in patients with immediate, early, intermediate, delayed or late group were 2/60, 2/60, Counting figure (CF) 3 meters (m), CF2 m and Hand Movement (HM) respectively. Only 48.48% patients of those repaired within 7 to15 days had significantly better (P < 0.001) BCVA (6/9-6/18) than the other groups. Only 19.35% patients of intermediate group achieved BCVA 6/18-6/24 (P < 0.001) which was comparatively better than the delayed and late group. Conclusions: Scleral buckle surgery for macular-off Rhegmatogenous Retinal Detachment has good post-operative visual outcomes if repaired within two weeks.
Highlights
Rhegmatogenous Retinal Detachment (RRD) is the separation of neurosensory retina from retinal pigment epithelium (RPE) in association1
One hundred and seventy adult phakic patients of either gender having primary Rhegmatogenous Retinal Detachment (RRD) with macula-off having visual acuity (VA) of 6/60 or less and who were able to estimate the exact time period for onset of significant visual loss were selected from outpatient department
Exact cut off period for duration of macula off and surgical intervention is difficult to establish but majority agree that visual recovery is inversely proportional to the duration of macula off
Summary
Rhegmatogenous Retinal Detachment (RRD) is the separation of neurosensory retina from retinal pigment epithelium (RPE) in association1. Rhegmatogenous Retinal Detachment (RRD) is the separation of neurosensory retina from retinal pigment epithelium (RPE) in association. Dr ShahidWahab MBBS, MCPS, FCPS, Professor of Ophthalmology, 3. Dr Hargun Das Lakhani MBBS, FCPS, Assistant Professor, 1-3: Ophthalmology Unit I, Dow University of Health Sciences, Civil Hospital, Karachi, Pakistan. Exact cut of period regarding how earlier fresh RRD with macula off should be repaired remain a debatable issue. Hassan and associated[4], and Schwartz and coworkers[5] agree that surgical repair of detached retina earlier than 10 days shows best results to restore visual acuity with macula off. The underlying principles in the scleral buckling (SB) are indentation of globe wall to provide RPE apposition to the neurosensory retina and closure of the hole / break by Cryotherapy.
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