Purpose: To determine the impact of metamorphopsia on quality of life after successful retinal detachment (RD) surgery and to determine which retinal changes are related to the most severe distortions. Design: This was a prospective, observational, consecutive study. Methods: The study included 58 eyes of 58 consecutive patients who underwent successful RD surgery. At 6 months postoperatively, the incidence and severity of metamorphopsia were assessed by a quality-of-life questionnaire. Microstructure retinal changes were studied with spectral domain optical coherence tomography (OCT). The questionnaire score was compared with pre- and postoperative OCT findings. Results: Overall, 20 patients (34.5%) had metamorphopsia. Outer retinal folds (ORFs) and the macular status before surgery, together with postoperative ORFs and decrease in ellipsoid and/or interdigitation photoreceptor zone reflectivity, were identified as risk factors of developing metamorphopsia (relative risk, 1.7–4.8). The most severe visual distortions were associated with ORFs. Conclusion: Metamorphopsia is a frequent occurrence after RD surgery and its impact on patients’ quality of life appears to be limited. While it may be difficult to prevent photoreceptor loss occurring after surgery, limiting postoperative ORFs may be helpful in reducing their incidence.

To analyze the data of the adverse events collected in a single major eye bank (EFS Bourgogne Franche Comté, Besançon, France) for the year 2013 and to report the French data of biovigilance provided by the French National Agency for Medicines and Health Products Safety (ANSM) between 2010 and 2013. we have set up a study of adverse events in 2013, in collaboration with a single eye bank (EFS Bourgogne Franche Comté, Besançon, France). A survey was sent to the surgeon for each delivered corneal button by the eye bank in 2013. They were asked for each grafted patient performed in their center, the type of graft (penetrating keratoplasty, anterior keratoplasty or endothelial keratoplasty), the occurrence of adverse events (primary failure, infectious keratis, endophthalmitis, immune rejection, and other events) and the time interval between surgery and events (Less than 1 postoperative month, between 1 month and 1 year postoperatively, >1 year postoperatively). In 2013, 407 corneal buttons were delivered by the eye bank of Besançon in 21 medical centers which performed corneal grafts and we sent 407 surveys. We received 243 completed questionnaires (59.75%) from 11 centers (52.38%). The global reported rate of adverse events was 27.54% of the graft (n = 65/236 corneal grafts performed in 11 centers in 2013; 20% of Primary graft failure, 11% of infectious keratitis, 1% of endophthalmitis, 34% of rejection, 34% of other incidents). 30.16% of complications were noticed before the first month after surgery versus 52.38% of complications noticed between the first month and the first year after surgery and 17.46% of complications noticed after the post-operative first year The most common causes of adverse events after PK were Immune rejection (13.17%), surgical causes (5.98%) and infection (4.79%) and after EK were Primary graft failure (8.2%) and surgical causes (19.67%). In 2013, in France 0.83% of adverse events were notified in ANSM. For the 236 performed graft issued from a major eye bank (EFS Besançon) in 2013 the global reported rate of post-graft adverse events was 27.54% of the grafts (20% of Primary graft failure, 11% of infectious keratitis, 1% of endophthalmitis, 34% of rejection and 34% of other incidents). Compared to the ANSM data (0.83% of adverse events reported in 2013) this rate is high. This difference can be explained by the low rate of annual notification to the ANSM and shows that biovigilance in France must be more developed. Since biovigilance needs constant improvement for the safety of the graft system, training, information for practitioners, simplifications of procedures and international standardization of the definition are the main points that could be improved.

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PurposeTo study the anatomical and functional recovery after retinal detachment surgery (RD) by studying the reflectivity of the ellipsoid band (ISe) measured in en‐face OCT and multifocal electroretinography (M‐ERG) and investigate the factors involved in the results.MethodsProspective study of 39 patients operated successfully of RD and examined at baseline and at 3 (M3) and 6 months (M6). SD‐OCT and M‐ERG were performed at each visit. A coronal view of the ganglion cell layer (GCL) and the cone inner segment ellipsoid (ISe) band were reconstructed on en‐face OCT. The mean reflectivity in the 2 central degrees was calculated using image J and expressed as a gray level ranging from 0 (black) to 256 (white).ResultsM‐ERG waves amplitudes were reduced in RD involving the macula (p < 0.05). Best corrected visual acuity (BCVA) was correlated to the M‐ERG amplitudes at 6 months (p < 0.01). CGL and ISe reflectivity were lower in the group with macular involvement (p < 0.05). ISe reflectivity was correlated with the BCVA at M3 and M6 (p < 0.001). ISe reflectivity was also related to the duration of the macular detachment (p = 0.01). However, we did not observe any correlation between GCL reflectivity and BCVA. While, the GCL reflectivity was correlated with the RMS amplitudes (p = 0.03), there was no correlation between M‐ERG amplitudes and ISe reflectivity.ConclusionsM‐ERG represents a valuable tool in the assessment of visual function after RD. En‐face OCT brings new insight on the integrity of the retinal structures after surgery, and shows that both inner and outer retinal layers are impaired after RD reattachment.

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