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J. W. Josephson, M. M. Lai, J. R. Minarcik, H. H. Pham, J. D. Kim, M. A. von Fricken; The Effect of Symptom Duration on Outcomes Following Vitrectomy Repair of Primary Macula-Off Retinal Detachments. Invest. Ophthalmol. Vis. Sci. 2010;51(13):6070.
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To examine the effect of symptom duration on visual and anatomic outcomes following vitrectomy repair of primary macula-off retinal detachments.
This is a retrospective, consecutive, interventional case series. All eyes underwent repair of the macula-off retinal detachment with a standard 3-port pars plana vitrectomy. Eyes with previous retinal surgery, giant retinal tear, grade C or higher proliferative vitreoretinopathy, or < 2 months follow-up were excluded from the study. The main outcome measures studied were final best-corrected visual acuity (BCVA) and single surgery anatomic success rate as dependent variables on the duration of macular detachment symptom. Visual acuity analysis was performed on all pseudophakic eyes by the final follow-up visit.
92 eyes of 91 patients met inclusion criteria, with a mean follow-up length of 26 months (range 2-121) and mean duration of macular detachment symptom of 9.4 days (range 0-60). The mean final BCVA was 20/40 (range HM-20/20), with 68% (n=63) of all patients obtaining 20/40 or better final BCVA. Patients with symptom duration of 8 days or less achieved better final BCVA (mean 20/34, n=50) than patients with longer symptom duration (mean 20/49, n= 42) (T-test, p=0.042). After 8 days of macular detachment, no significant difference was seen in final BCVA (T-test, p>0.10). The overall single surgery anatomic success rate was 86% (79 of 92 eyes). There was no correlation between the single surgery anatomic success rate and duration of macular detachment symptom (Fisher's exact test, p>0.10).
Vitrectomy results in good final visual outcome for patients with primary macula-off retinal detachments. Surgery within 8 days of the symptom onset yielded better visual outcomes. After 8 days, visual outcome was not affected by timing of surgery. Anatomic outcome following vitrectomy repair is not affected by symptom duration.
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