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P. B. Henrich, T. Josifova, D. Klaessen, J.-O. Kono-Kono, U. Schneider; Macula-Off Retinal Detachment: A Matter of Time?. Invest. Ophthalmol. Vis. Sci. 2008;49(13):5246.
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To determine the influence of the time-span between initial symptoms and surgical intervention on post-operative visual acuity gain in patients with rhegmatogeous macula-off retinal detachment.
We retrospectively evaluated the medical records of 62 consecutive patients having undergone scleral buckling surgery for rhegmatogenous macula-off retinal detachment. Based on these records, we determined the correlation of gender, age, refraction, number of retinal breaks, development of cataract during follow-up, pre-operative visual acuity and timing of surgical intervention with final visual acuity and post-operative visual acuity gain. Mean follow-up time was 12.68 months.
Among the analyzed variables, a correlation with final visual acuity was found only for pre-operative visual acuity and lag time between the beginning of symptoms and surgical intervention. A correlation with visual acuity gain was found only for the timing of the surgical procedure. When divided into subgroups operated 0, 1-3, 4-6, or 7-9 days after the beginning of symptoms, respectively, visual recovery was better the earlier patients underwent surgical repair. Compared to surgery at day 0, results showed to be statistically significantly less favourable, however, only for patients operated 4 or more days after the beginning of symptoms and not for the subgroup operated within the first 1-3 days.
A short interval between the beginning of symptoms and surgical intervention favours visual acuity gain after scleral buckling surgery for rhegmatogenous macula-off retinal detachment. However, statistical significance was observed only for patients operated 4 or more days after initial symptoms. The first three days after the beginning of symptoms seem to represent a relatively safe interval during which surgery may be postponed without compromising the patient’s visual prognosis.
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