Abstract
Purpose :
To analyze preoperative RD characteristics and postoperative complications, and to evaluate the functional and morphological outcomes of patients with SO tamponade due to primary rhegmatogenous retinal detachment (primRD) and rhegmatogenous re-detachment (reRD).
Methods :
This prospective study included 75 patients at the Department of Ophthalmology, Medical University of Vienna. Patients with primRD and reRD were evaluated in a complete ophthalmic examination including BCVA and OCT before and after silicone oil removal (SOR). Postoperative follow-up examinations were performed 1, 3 and 6 months and at least one year after SOR.
Results :
The primRD group comprised 35 eyes and the reRD group 40 eyes. The mean follow-up was 36±24/32±24 months in the primRD/reRD groups. The duration of SO tamponade was 9±4/12±11 months in the primRD/ reRD groups (p=0.088).
The number of foveal detachments (p=0.44) did not vary between primRD (71%) and reRD patients (57%). RD height was rather highly elevated in the primRD group (62%), whereas shallow or flat in the reRD group (85%; p<0.001). No difference in PVR reaction was found for both groups (p=0.40). Eight patients (11%) developed a re-detachment of the retina following SOR, whereof 5 eyes in the primRD group (14%) on average 20±11 days (range: 3 to 33 days) and 3 in the reRD group (8%) on average 26±20 days (range: 9 to 55 days) after SOR.
The preoperative OCT evaluation revealed a high rate of morphological changes such as ERM (primRD: 26%; reRD: 61%), CME (primRD: 10%; reRD: 44%) and FTMH (primRD: 8%; reRD: 9%) in the reRD compared with the primRD group (ERM: p=0.18; CME: p=0.04; FTMH: p=0.51). No such difference was observed in the postoperative evaluation. IS/OS line disruption was similar in both groups (primRD: 58%; reRD: 66%) before SOR. No difference was found regarding pre- and postoperative VA (0.91±0.54/0.90±0.54logMar primRD/reRD preoperative; 0.76±0.56/0.71±0.53logMar primRD/reRD at the last follow-up; p=0.96/ p=0.70). IS/OS line integrity (0.43±0.31logMar) was associated with better functional results than interrupted IS/OS lines (0.86±0.43logMar; p<0.001).
Conclusions :
Morphological changes including ERM, CME and FTMH were more pronounced in the re-detachment group, but only in the OCT before SOR. Interestingly, the pre- and postoperative functional outcomes were similar in both groups with IS/OS integrity being a factor of good functional outcome.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.