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Kristen Harris Nwanyanwu, Leslie Niziol, David Musch, David Zacks; Are outcomes in primary retinal detachment repair related to distance away from an academic medical center?. Invest. Ophthalmol. Vis. Sci. 2013;54(15):4410.
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© ARVO (1962-2015); The Authors (2016-present)
To determine if distance from an academic medical center influences outcomes in patients who undergo primary rhegmatogenous retinal detachment repair.
We performed a retrospective chart review on patients >18 yo, who underwent primary repair of a rhegmatogenous retinal detachment over the course of 1 year. Sociodemographics; distance and time to Kellogg Eye Center (KEC) in Ann Arbor, Michigan; extent of retinal detachment at presentation; whether the detachment was macula-off or macula-on; pre-operative and post-operative visual acuity; pre-operative and post-operative intraocular pressure; and whether or not the retina was attached at baseline, 3 months, and 12 months were recorded. SAS 9.3 was used for all data analysis. Sociodemographic information was summarized with means, standard deviations, frequencies, and percentages. Distance and time were calculated using the Google maps. ANOVA, Kruskal-Wallis, Tukey adjusted pairwise comparison, and t-test were applied.
85 patients met inclusion criteria and 1 patient contributed both eyes to the study. The mean(SD) age of symptom onset in eyes was 57.5(11.1) years. The majority of patients were identified as white (93.4%) and the mean distance travelled was 37.4 miles and 45.0 minutes from KEC. The mean presenting visual acuity measured 0.65 in logMAR units; the median presenting IOP measured 14.0 mmHg; 42.3% of eyes presented with 1 quadrant detached, while 38.5% presented with 2 quadrants detached, with the median being 2 quadrants. When the distance values were divided into tertiles, the mean number of quadrants detached at presentation increased with distance, but was not found to be statistically significant (p=0.09). There was no correlation between distance and logMAR visual acuity or the number of quadrants detached at baseline. Baseline and 3 month logMAR worsened with increase in number of quadrants detached at baseline (p<0.0023 for both values). By three months, a significant difference between the visual acuity of the phakic and pseudophakic eyes developed (p=<0.0001), with phakic eyes having worse logMAR.
While there is a trend towards an increase in number of quadrants detached at presentation in those at increased distances from KEC, distance does not appear to negatively impact outcomes in surgically repaired primary retinal detachment.
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