Visual recovery after retinal detachment

Ross, William H.; Stockl, Frank

doi:10.1097/00055735-200006000-00007

Cited by 66 publications

(56 citation statements)

References 12 publications

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“…[23][24][25] The results presented here demonstrate that there is a worse outcome following foveal involvement and therefore, as the rate of detachment cannot be accurately predicted, Table 2 The proportion of patients with 6/9 vision or better at follow-up and the relationship with variables that were significantly related to follow-up vision after multivariate analysis 6/9 or better vision with variable (%) surgeons need to perform prompt surgery for fovea on detachments to avoid progression and foveal detachment. 26 Surgeons have been reassured by publications that show no difference in visual recovery in patients with foveal off RRD and varying duration of symptoms in the first week [27][28][29][30][31] or first 10 days. 32 This has lead to Ross et al 29 suggesting that macular off RRD can wait for a scheduled operating list.…”

Section: Discussionmentioning

confidence: 99%

Characteristics of rhegmatogenous retinal detachment and their relationship to visual outcome

Williamson

Shunmugam

Rodrigues

et al. 2013

Eye

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Aims To examine pre-operative characteristics of rhegmatogenous retinal detachment (RRD) and their relationship to visual acuity (VA) following surgery. Methods Review of prospectively completed electronic database. Baseline characteristics, retinal drawings and outcomes were analysed. Results In all, 847 eyes from 847 patients with a mean age of 62.2 years, 60% males, and 56% right eyes were studied. Mean follow-up was 9.6 months. Preoperative VA correlated with final VA (r 2 ¼ 0.21, Po0.0001). Median postoperative VA was 6/9 (Logmar 0.18, quartiles ¼ 0.0-0.48) and was significantly related to anatomical success: 70.15% achieved 0.18 or better with fully attached retina and primary success, whereas only 8.33% achieved this when the retina was not fully attached at final follow-up (failure) (Po0.0001). Univariate analysis found multiple variables associated with achieving 0.18 postoperative vision, however, multivariate analysis revealed only primary anatomical success with surgery; absence of proliferative vitreo-retinopathy (PVR), betterpresenting VA and fewer quadrants of detachment were associated with a better visual outcome (r 2 ¼ 0.26, Po0.0001). Patients with a clinically attached fovea achieved better vision than patients with a clinically detached fovea, independent of the visual loss duration. With foveal detachment however, postoperative VA was better in patients with 1-3 days of visual loss compared with 4-6 days (P ¼ 0.013). Conclusions Failure of primary surgery, PVR, extensive RRD and poor-presenting VA are risk factors for poorer visual outcome following surgery for RRD. Fovea off RRD at presentation achieved poorer postoperative VA than fovea attached and visual outcome was poorer when there was a longer duration of visual symptoms.

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Section: Discussionmentioning

confidence: 99%

Characteristics of rhegmatogenous retinal detachment and their relationship to visual outcome

Williamson

Shunmugam

Rodrigues

et al. 2013

Eye

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“…Burton and Lambert [19] and Ross and Kozy [5] have recently examined results after SB surgery within the first week in eyes with macula-off RRD and showed no statistically significant difference in the postoperative anatomical reattachment rate or final VA. Others like Hartz et al [1] compared emergency versus regular scheduled retinal detachment surgery and found no evidence that delaying the surgery may contribute to a worse visual outcome regardless of the status of the macula. Also Ross and Stockl [7 ]revealed that macula-off RRD can be treated with less urgency and may wait for the next scheduled available operating room. Our series divided all patients into several subgroups with different lengths of DMD and determined similar results.…”

Section: Discussionmentioning

confidence: 99%

“…While some studies hypothesized the preoperative VA as the most reliable predictor for visual and anatomical recovery, others claimed DMD as the greatest impact on the postoperative outcome after SB surgery. However, these studies did neither separate macula-on from macula-off RRD, nor exclude eyes with any other significant preoperative ocular pathology in their analyses [2, 3, 7]. …”

Section: Introductionmentioning

confidence: 99%

“…A number of series correlated the anatomical success after SB with the DMD of 1 week [7], 2 weeks [4], 1 month [8], 2 months [9] and 6 months [10] reporting worse outcomes with prolonged DMD [11]. Burton [4] demonstrated in patients with a DMD of 9 or less days a significantly higher incidence to obtain a final VA of ≥0.4 compared to patients with a prolonged DMD of 10 days or more, and calculated an exponential fashion between the visual recovery and the DMD.…”

Section: Introductionmentioning

confidence: 99%

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Visual Recovery after Scleral Buckling Surgery in Macula-Off Rhegmatogenous Retinal Detachment

Liu

Meyer²,

Mennel³

et al. 2006

Ophthalmologica

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Purpose: The primary goal of this study was to investigate the functional results after scleral buckling (SB) surgery in macula-off rhegmatogenous retinal detachment (RRD), with more or less than 7 days’ duration of macular detachment (DMD). The secondary outcome measure was to determine the long-term functional results in these two groups 5 years after SB surgery. Methods: The retrospective studies included 96 eyes of 96 patients with primary, uncomplicated, macula-off RRD. Two studies, one with a short-term follow-up and one with a long-term follow-up, were performed, and in both studies the eyes were divided into two groups according to the DMD. In study I, 96 patients were divided into DMD ≤7 days (n = 73) and prolonged DMD more than 7 days (n = 23) with a postoperative follow-up of at least 3 months (mean 43.5 months). In a subgroup analysis, patients were divided into acute DMD ≤3 days (n = 37) and subacute DMD ≧4 days and ≤7 days (n = 36). Study II included 47 patients with a follow-up of at least 5 years (mean 6 years). All patients were divided into(subacute) DMD ≤7 days (n = 36) and (prolonged) DMD of >7 days (n = 11). Additional preoperative predictive factors including DMD, preoperative visual acuity (VA) and patients’ age at the time of the RRD were correlated with the postoperative VA. Results: In study I, the mean final VA was significantly better (0.45) after a DMD of less than or equal to 7 days, compared to patients with a DMD of more than 7 days (0.22; Student’s t test, p = 0.02). VA ≧0.4 was achieved in 68% with a subacute DMD compared to 52% in patients with prolonged DMD (χ² test, p < 0.001). However, the postoperative VA (0.48 ± 0.09) in eyes with DMD of 1–3 days was similar (0.42 ± 0.07) to eyes with DMD of 4–7 days (Student’s t test, p = 0.455). We divided the 96 patients into 2 groups according to a preoperative VA. Eyes with a preoperative VA ≤0.1 (n = 62) had a significantly lower final VA compared to eyes with a preoperative VA >0.1 (n = 34; Student’s t test, p < 0.001). Patients 75 years of age or younger were more likely to achieve a VA of 0.4 or better after SB surgery than older patients (more than 75 years; χ² test, p = 0.008). In study II, VA improved (by a mean of 1.60 ± 0.02 lines) during the follow-up period from 0.32 ± 0.08 at the 3-month follow-up to 0.46 ± 0.10 at the 5-year follow-up. Eyes with a subacute DMD had a significantly better VA than eyes with a prolonged DMD (Student’s t test, p = 0.004). Patients aged 75 years or less were more likely to achieve a VA of 0.4 or better than patients older than 75 (χ² test, p = 0.003). Conclusion: The time point of SB surgery has no statistical impact on the final visual recovery in patients with an acute primary macular-off RRD of less than or equal to 7 days. A delay of SB surgery within this time frame does not contribute to an impaired final visual outcome. There was no evidence, that primary macula-off RRDs are emergencies, which cannot wait for a systemic evaluation of the RRD and surgical t...

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“…Many factors have been found to influence recovery of vision following surgery in the general population, including patient age, refractive error (no or mild myopia), duration of retinal detachment, preoperative visual acuity, lens status, extent of detachment, and intraoperative and postoperative complications. [9][10][11][12] However, even though these variables have been studied extensively, the relationship between the various factors and surgical outcome of RRD in highly myopic patients have not been well established in a larger series.…”

Section: Introductionmentioning

confidence: 99%

Anatomical and functional outcome of surgery of primary rhegmatogenous retinal detachment in high myopic eyes

Cheng

et al. 2006

Eye

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Purpose To analyse the anatomical and functional outcome of surgery for primary rhegmatogenous retinal detachment (RRD) in highly myopic eyes. Methods We retrospectively reviewed the medical records of 111 high myopic patients (111 eyes) with primary RRD treated by scleral buckling or pars plana vitrectomy in a tertiary referral university hospital. The postoperative retinal status and best-corrected visual acuity were recorded. Risk factors including age, refractive error, duration of retinal detachment, preoperative visual acuity, extent of detachment, and intraoperative and postoperative complications were evaluated. Multiple logistic regression analysis was used to determine the independent correlation of each variable on anatomical and functional outcome. Results Primary surgery resulting in retinal reattachment was achieved in 96 (86.5%) eyes with more than 6 months follow-up (range, 6-60 months). Sixty-eight (61.3%) eyes had postoperative corrected visual acuity 20/50 or more. Postoperative complications in high myopic eyes were variable, and the most common was cataract progression (19.8%). Upon multiple logistic regression analysis, young patients had significantly better anatomical outcome, although the variables including less refraction error, better preoperative visual acuity, scleral buckling procedure, and less surgical intervention showed better functional outcome in our series. Conclusions The anatomical outcome of surgery for primary RRD in highly myopic eyes was favourable, and young patients tended to have a higher success rate. Functional outcome was significantly correlated with refractive error, preoperative visual acuity, surgical procedure, and number of vitreoretinal surgery.

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Visual recovery after retinal detachment

Cited by 66 publications

References 12 publications

Characteristics of rhegmatogenous retinal detachment and their relationship to visual outcome

Characteristics of rhegmatogenous retinal detachment and their relationship to visual outcome

Visual Recovery after Scleral Buckling Surgery in Macula-Off Rhegmatogenous Retinal Detachment

Anatomical and functional outcome of surgery of primary rhegmatogenous retinal detachment in high myopic eyes

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