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N. J. Khan, M. M. Lai, E. Weichel, D. M. Berinstein; Visual Outcomes in Early versus Late Macula-On Retinal Detachment Repair. Invest. Ophthalmol. Vis. Sci. 2009;50(13):3179.
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To describe the single surgery anatomic success rates and visual outcomes of macula-on retinal detachment repaired within 24 hours compared to later than 24 hours.
All eyes underwent surgical repair of the macula-on retinal detachment with a scleral buckle, standard 3-port pars plana vitrectomy or combination of both procedures. The duration from the initial exam to the time or operation was categorized as early surgical repair (<24hours) versus late surgical repair (>24 hours). Visual acuity analysis excluded all eyes with a preoperative best-corrected visual acuity (BCVA) worse than 20/.25 due to preexisting retina/optic nerve disease or media opacity. Statistical analysis was completed using SPSS version 15.0.
Sixty six macula-on retinal detachments, 42 phakic and 24 preoperative pseudophakic eyes had retinal detachment repair with a median time to surgery of 1.0 ± 2.1 (range 0-10) days.. The mean age in early repair (59 years) was not statistically different in the late repair group (53 years) (T-test, P=0.12). The median duration of symptoms was 3.5 ± 90.1 days (range 0-730 days). The median clock hours of retinal detachment was 3.0 ± 1.8 (range 1.0-10.0) with no difference in the mean duration within each group (T-test, P=0.73). The overall single surgery anatomic success rate was 59 of 66 eyes (89%). The single surgery anatomic success rate between both the early [32 of 37 (87%)] versus late [27 of 39 (93%)] repair groups showed no difference (Fisher exact two-tailed exact test, P=0.45). The median time of documented follow up was 6.5 ± 8.9 (0.9-28.4) months with the mean final logMAR BCVA of no statistical difference between the two groups [early (0.11±0.03) versus late (0.18±0.03), T-test; P=0.11]. The rates of complications demonstrated no difference between the early versus late surgical repair group [postoperative glaucoma (P=0.5), postoperative hemorrhage (P=0.19)].
Late (>24 hours) macula-on retinal detachment repair does not appear to cause worse visual outcomes compared to early surgical intervention (less than 24 hours.) The surgical success rate in early versus late macula-on retinal detachment repair appears similar. There was no difference in the complication rates between the two groups.
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