Abstract
Purpose :
To evaluate long-term surgical outcome of rhegmatogenous retinal detachment (RD) repair, regarding functional results, treatment method and post-operative complications.
Methods :
Over a six year period this prospective study included patients who received surgical treatment due to retinal detachment at the department of ophthalmology, medical university Vienna. Inclusion was set for primary detachment, re-detachment or schisis-detachment, whereas exclusion for tractive and exudative RD or post vitrectomy. Post-operative assessment involved a complete ophthalmic examination: Snellen visual acuity (converted to Logmar), slit-lamp examination, biomicroscopy and optical coherence tomography. Further, we recorded method of repair and surgical outcome; follow-up was set for at least one year.
Results :
Data from 558 patients who received surgical treatment due to any kind of RD between January 2008 and December 2013 were evaluated, whereof 345 patients with a mean age of 56.8±13.8years (male: n=210, female: n=135) met the inclusion criteria. Mean follow-up was 2.08±1.1years. 35.1% of the patients were pseudophakic (n=121) and 56.8% had a macula-off RD (n=196). The main surgical method was vitrectomy with gas tamponade (61.4%) followed by scleral buckle surgery (17.1%). Primary attachment was achieved in 79.4% (n=274), 59 patients required second surgery and twelve patients more than two surgeries. Out of 224 pre-operative phakic patients 144 required cataract surgery over an interval of 1.13±0.81years and 25 patients membrane peeling about 0.95±0.76years post-surgery. Mean visual acuity (VA) pre-operatively was 0.98±0.79Logmar and increased significantly to 0.36±0.46Logmar (p<0.01). Macula-off RD patients had a significant worse pre-operative VA: 1.43±0.64Logmar than macula-on RD: 0.38±0.54 (p<0.01) .Macula off RD patients showed also significant improvement of BCVA to 0.42±0.52Logmar at the end of follow-up time (p<0.01).
Conclusions :
In conclusion, a strong trend toward vitrectomy with gas tamponade can be detected. In two thirds of phakic patient’s cataract progresses, that surgery is necessary. In regard to vision recovery a significant increase could be shown for the selected population.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.