Successful surgery and institutional incidence of rhegmatogenous retinal detachments in Teaching Hospital, Kurunegala, Sri Lanka: 3-year results from a tertiary care centre in North-Western province of Sri Lanka

Abstract

Introduction: Rhegmatogenous retinal detachment (RRD) is a potentially blinding condition if not treated. Major proportion of RRDs in Teaching Hospital were complex RRDs.Objectives: To assess the surgical success (reattachment) and other characteristics of RRD repairs and to determine the yearly institutional incidence of RRDs in Teaching Hospital, Kurunegala, Sri Lanka.Methods: Observational study of retrospective case review of RRDs operated by single vitreoretinal surgeon from 30.09.2018 to 30.09.2021. Retinal reattachment is the primary outcome measure. Modalities of treatment were either pars planar vitrectomy (TPPV) or scleral buckling (SB). Perfluoropropane or Silicone oil 1000cst was used as tamponading agent indicated by the complexity of RRD. All the cases were performed without endolaser, or a wideangle viewing system and cryopexy used for primary sealing of tears. When indicated TPPV was combined with SB. Failed SBs reoperated with TPPV and tamponade.Results: Study involved 309 eyes of 306 patients where 248 (80.26%) eyes of 246 offered TPPV and 61 (19.74%) eyes out of 60 offered SB. Mean age was 51.32y (7-80y) and 198 (65%) males and 108 (35%) females. Mean number of surgical interventions 1.608 (1-6). Overall surgical success over 3 years in TPPV group was 87.096% (216/248) and in SB group 77.049% (47/61) and average surgical success in both groups was 82.072% (263/309). Steady rise in surgical success in TPPV group observed over years achieving 93.55% in 2021. Average institutional incidence of RRDs was 1.346 per 100 eye admissions to eye unit.Conclusion: In a low facility setup for vitreoretinal services high success rate achieved has helped to prevent blindness due to RRD.