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Mitul Mehta, Robert Sisk, Christopher Riemann; Management and Outcomes of Bilateral Simultaneous Rhegmatogenous Retinal Detachments. Invest. Ophthalmol. Vis. Sci. 2013;54(15):2847.
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To describe a series of patients with bilateral simultaneous rhegmatogenous retinal detachment (BSRRD), and their surgical management.
IRB approved, retrospective chart review of all adult patients who presented to the Cincinnati Eye Institute with BSRRD between 1989 to 2006 requiring surgical management without prior retinal detachment (RD) or history of ruptured globe. Thirty-three patients (66 eyes) met the inclusion criteria and underwent surgical repair. Eyes amenable to laser treatment alone were excluded. Snellen visual acuity was converted to LogMAR for statistical analysis.
There were 12 patients (with 24 eyes) who were younger than 40 years old, 11 of those 24 eyes (46%) had atrophic holes as cause of RD, 20 of 24 had lattice degeneration, 22 of 24 had no posterior vitreous detachment (PVD) at presentation. In the 42 eyes of patients over 40 years of age, 20 of them had retinal tears as the cause of the detachment. Of our 33 patients, 15 had both maculae spared, 8 had both maculae involved in the detachment, and 10 had one eye in which the RD involved the macula and one eye did not. We achieved primary anatomical reattachment in 97% of eyes. Eight eyes had recurrent detachment, 6 (9.1%) of which required reoperation. There was a statistically insignificant difference in the postoperative visual acuity between the first and second operated eyes (0.18 1st eye, 0.45 2nd eye with p = 0.059).
RD in the absence of a specific initiating event may represent a less progressive process, in contrast to the rapid progression of RD resulting from an acute PVD. In the absence of PVD and in eyes with evidence of chronicity to the RD, RD progressed slowly and allowed repair of the eye with the detached macula first without further visual compromise to the second eye. This may warrant a change in the paradigm of surgical management of BSRRD.
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