Retrospective Study of Rhegmatogenous Retinal Detachments Secondary to round Retinal Holes

Abstract

The authors aim to analyze the incidence, characteristics, surgical management, and outcome of patients presenting to St Thomas' Hospital with a rhegmatogenous retinal detachment secondary to atrophic round retinal holes. This is a retrospective collation of patients presenting to a single surgeon with a round hole-associated retinal detachment between 2001 and 2009. Specific collation of demographics, retinal detachment features, choice of management, complications, requirement for further surgery, and ultimate surgical success with final visual acuity is reported. Fifty-six patients with a retinal detachment secondary to a round hole were identified (4.49% incidence). The cohort had a median age of 28.9 years (range 14 to 39) and a female predominance (64%). The median spherical equivalent refractive error was -5.5 diopters (range -1 to -18). The commonest quadrant with retinal holes was the inferotemporal quadrant (40% of patients). Approximately half of our cohort were identified to have lattice degeneration at any site and in either eye. The majority of patients received an external nondrainage procedure (92%) with cryotherapy (88%) and an explant (94%). Three patients required further surgery to achieve retinal reattachment and 12% required surgery for a retinal detachment in the fellow eye. At final follow-up, 78% achieved a visual acuity of 0.18 logMAR (6/12 Snellen) or better and the median final visual acuity was 0.00 logMAR (6/6 Snellen). Retinal detachments secondary to round holes have consistent characteristic features (young, myopic, female, inferior detachment). Surgical management is increasingly advocated and most achieve primary surgical success with a good final visual acuity.