Abstract
Purpose: :
To determine if the timing of retinal detachment repair after open globe injury with concurrent or subsequent retinal detachment affects visual outcome.
Methods: :
Retrospective study of 69 eyes with open globe injury and concurrent or subsequent retinal detachment over an 11 year period. The amount of time was determined between the detection of the retinal detachment and its surgical repair, either by scleral buckle or vitrectomy. Patients were excluded if this time was more than 100 days. If the patient had more than one surgery for retinal detachment (either recurrent or new), the timing of only the first surgery was studied. Outcome was based on best logMAR visual acuity prior to the surgery compared to the best logMAR visual acuity at any follow-up visit after the surgery.
Results: :
The average time between the original open globe injury and detection of the retinal detachment was 29.67 +/- 56.9 days (range 0-496 days). The average time between detection of the retinal detachment and its repair was 15.7 +/- 19.6 days (range 0-96 days). All patients experienced either no change or an improvement in their vision during at least one follow-up visit after the surgery. Best visual outcomes were significantly higher for surgeries performed between 0-14 days after detection of the retinal detachment, with mean gain of 0.97 +/- 0.85 logMAR units, compared with surgeries done >14 days after, with mean gain of 0.45 +/- 0.63 logMAR units (t-test, two-sided, P=0.01). There was no significant difference in best visual outcomes between surgeries done in the first 7 days compared to those done between days 8-14 (t-test, two-sided P=0.86).
Conclusions: :
Patients with open globe injury and concurrent or subsequent retinal detachment may have better visual outcomes if retinal detachment repair is performed within 14 days of detection of the detachment.
Keywords: trauma • retinal detachment • vitreoretinal surgery