Abstract
Purpose:
Clinical data from eye surgeries performed in Argentina is scarce, yet much required to assess the quality of care. The purpose of this work was to determine the anatomical outcome and associated factors after surgery for rhegmatogenous retinal detachment (RRD) in Argentina.
Methods:
Retrospective chart review of patients operated by one surgeon from September 2012 to September 2014 in 4 different centers. Anatomical outcome was defined as successful if the retina remained fully attached 30 days after tamponade extraction, as failure if the retina was not fully attached and no further surgery was deemed appropriate, or as indeterminate if tamponade was still present in the eye or another surgery was scheduled to attach the retina at the end of the study period. Logistic regression with all recorded preoperative variables was used to find anatomical outcome predictors.
Results:
68 cases were collected, 3 (4%) of which were lost to follow-up and were not analyzed. Mean age was 66 years (33-97), 42% were female and 45% were phakic eyes. In average, 7 days (0-180) passed from onset of symptoms to first visit, and another 7 days (0-40) passed until the first surgery. At first surgery, 71% of eyes had macula-off detachment, 17% had only one detached quadrant and 32% had all quadrants affected, whereas the extent of proliferative vitreoretinopathy (PVR) was 55% grade 0, 19% grade A, 7% grade B, 19% grade C and 0% grade D. Surgical procedures were: pneumatic retinopexy (1%), scleral buckle (20%), vitrectomy (71%) and vitrectomy+buckle (8%). One surgery was performed in 65%, two surgeries in 23% and three surgeries in 12% of the cases, with 62% of success, 10% of failure and 28% of indeterminate state at the end of the study. True success rate was 85%. Factors negatively associated with success were, from most to least correlated: PVR grade, number of detached quadrants, time to surgery, and inferior detachment.
Conclusions:
Although the true success rate and the factors associated are similar to those reported elsewhere (PVR grade being the most important), the time from disease onset to surgery and the type of procedure reflect local variations that might be related to the Argentinian health system. These findings highlight the influence of PVR on surgical outcome and the unmet need for additional therapeutic strategies for this disorder.