Abstract
PurposeTo determine the influence of residual submacular fluid (SMF) on the recovery of function and structure of the retina after successful rhegmatogenous retinal detachment (RRD) reattachment.MethodsWe reviewed the medical records of all patients who had undergone successful RRD repair by scleral buckling (SB) surgery or by pars plana vitrectomy (PPV) from March 2011 to August 2014. Spectral-domain optical coherence tomographic images of the macular regions were used at 1, 2, 3, 6, 9, and 12 months following the surgery. The best-corrected visual acuities (BCVA) were evaluated at the same times.ResultsThe eyes with a macula-off RRD that were treated by SB surgery had a significant higher incidence of residual SMF (52%) than those treated by PPV (6.8%; P <0.001). Nevertheless, the postoperative BCVA was significantly improved in the eyes that had undergone SB surgery (P = 0.007). The postoperative BCVAs were not significantly different between the groups in which the SMF was absorbed (12 eyes) and not absorbed (13 eyes) within 1 month after the SB surgery. The photoreceptor outer segment length and the presence of a foveal bulge were not significantly different between these two groups at 12 months. Multiple regression analyses showed that the presence of a foveal bulge (β = 0.531, P = 0.001) and the duration of the retinal detachment before surgery (β = 0.465, P = 0.002) but not the duration of the SMF were independent factors significantly correlated with the final BCVA.ConclusionsThese results suggest that the postoperative residual SMF does not significantly disrupt the functional and structural recovery of eyes with macula-off RRD treated by SB surgery.
Highlights
A rhegmatogenous retinal detachment (RRD) is a common cause of visual impairments, and the main treatment for a RRD is a surgical reattachment of the retina [1]
The eyes with a macula-off RRD that were treated by scleral buckling (SB) surgery had a significant higher incidence of residual submacular fluid (SMF) (52%) than those treated by pars plana vitrectomy (PPV) (6.8%; P
These results suggest that the postoperative residual SMF does not significantly disrupt the functional and structural recovery of eyes with macula-off RRD treated by SB surgery
Summary
A rhegmatogenous retinal detachment (RRD) is a common cause of visual impairments, and the main treatment for a RRD is a surgical reattachment of the retina [1]. With the recent advancements in the vitrectomy instruments and techniques, PPV has become the first choice for many surgeons especially for patients with pseudophakic RRD [2]. Residual submacular fluid (SMF) is frequently found after successful SB surgery for macula-off RRD even when the retina appears to be fully attached by ophthalmoscopy, and all retinal breaks appear to be adequately sealed. Machemer reported this phenomenon when he described small collections of SMF after the resolution of experimental retinal detachment in owl monkeys [5]. Studies have reported a delayed absorption of SMF following SB surgery in humans [6, 7]
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