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Avni Patel, Dean Eliott, Leo A Kim, Demetrios G. Vavvas, John B Miller; Characteristics and Outcomes of Simultaneous Bilateral Rhematogenous Retinal Detachments. Invest. Ophthalmol. Vis. Sci. 2016;57(12):1048.
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© ARVO (1962-2015); The Authors (2016-present)
We present the largest case series of bilateral simultaneous rhematogenous retinal detachments reported to date in order to better understand visual prognosis and treatment of this rare and difficult managment situation.
20 patients (40 eyes) presenting to the Massachusetts Eye and Ear Infirmary (MEEI) between April 2000 and June 2015 with simultaneous bilateral rhegmatogenous retinal detachments were included in this study. A waiver of informed consent and Health Insurance Portability and Accountability Act authorization was granted by the IRB of MEEI for this medical records review. Statistical analysis was performed using a t-test and the Fischer exact test.
Of the 40 eyes, 35 eyes (88%) underwent surgical repair, 3 eyes underwent laser retinopexy, 1 eye was treated with cryo-pneumatic and 1 eye was observed. 21 eyes had scleral buckle (SB) placed, 9 eyes underwent primary pars plana vitrectomy (PPV), and 5 eyes underwent combined PPV with SB. 20 eyes underwent bilateral repair on the same day and 20 eyes were treated with staged repair.Primary reattachment rate in this series was 97.5% with one eye requiring a repeat procedure for failed cryo-pneumatic retinopexy. 28 eyes had a visual acuity of 20/40 or better at final follow-up while 3 eyes had a visual acuity of 20/200 or worse on final follow-up. Patients with mac-off retinal detachments had mean final visual acuity of 20/70 and patients with mac-on retinal detachments had a mean final visual acuity of 20/25, p-value = 0.0011. The mean final visual acuity for patients undergoing scleral buckling procedure with or without vitrectomy was 20/40 and the mean final visual acuity for patients undergoing PPV was 20/50 (p-value =0.2224).
While bilateral retinal detachments are a potentially blinding condition, this series shows visual outcomes may be quite good with the status of the macula being a significant predictor of visual outcome.Multiple treatment modalities utilized in this study and overall success of retinal detachment repair was higher in this study than previous studies with 90% of repairs not requiring second surgery for recurrent detachment.Furthermore, this study shows that PPV or a combination of PPV with SB in staged or same day repair may provide good success rate for reattachment compared with studies that have used scleral buckling alone and that there is no difference in visual outcomes.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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