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M. M. Zorn, M. Schmidbauer, G. K. Lang, G. E. Lang; Evaluation of Rhegmatogenous Retinal Detachments by Means of Visual Acuity and Optical Coherence Tomography. Invest. Ophthalmol. Vis. Sci. 2007;48(13):5745.
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To evaluate prospectively the macular architecture pre- and postoperatively (either after buckling surgery or pars plana vitrectomy (ppV)) by means of optical coherence tomography (OCT) and funduscopy and to assess the course of best corrected visual acuity (BCVA) before and after surgery for rhegmatogenous retinal detachment.
29 patients, age ranging from 18 to 77 years (mean age 57 years) with rhegmatogenous retinal detachment were examined according to a standardized protocol including pre- and postoperative BCVA, OCT examination of the macular area, ophthalmoscopy and fundus photography. Examinations were performed preoperatively, 6, and 12 weeks postoperatively. Evaluation of the macular attachment postoperatively was performed by means of clinical examination and OCT. Correlation of BCVA and macular attachment was performed.
Thirteen of 29 patients were treated by buckling surgery,16 by ppV. 23 patients needed one operation, 6 two operations and one patient needed three operations. 16 patients initially presented with a macular detachment, 6 of them were treated by buckling surgery and 10 by ppV. Preoperatively, BCVA ranged from hand motion to 1.0. (buckling procedure: median = 0.6; ppV: median = 0.067). At the last follow-up BCVA ranged from 0.05 to 1.25 (buckling procedure: median = 0.6; ppV: median = 0.25). When the macula was attached (pre- and postoperatively) BCVA changed from a median of 0.65 (preoperative) to 0.55 (last visit) (buckling surgery: from 0.6 to 0.7; ppV: from 0.65 to 0.4). If the macula was detached initially and was attached postoperatively BCVA improved from a median of 0.013 (preoperative) to 0.25 (last visit) (buckling surgery: from 0.025 to 0.4; ppV: from 0.013 to 0.175). The last follow-up examination showed that 4 patients suffered from a macular detachment, 3 in the buckling surgery group and one in the ppV group. Macula detachment was postoperatively more often verified by OCT examination than by clinical examination (4 vs 1).
Amelioration of BCVA was better in the ppV group. Reattachment of the macula occurs more often if ppV is performed. OCT examination helps in the postoperative management concerning persistent macular detachment.
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