Abstract
Purpose :
To evaluate outcomes of ultra-complex retinal detachment (UCRD) repairs performed at a large county hospital
Methods :
Retrospective chart review of patients treated at a large county hospital by supervised surgical retina fellows between September 2014-March 2017 who underwent an UCRD repair, defined as a funnel retinal detachment (RD); RD associated with ocular trauma; or RD requiring retinectomy, 5,000 centistoke silicone oil (SO) or perfluorocarbon heavy liquid (PFO). Patient were excluded if there was less than three months of follow-up. Outcomes measured were visual acuity (VA) at the 3-month time point, anatomical success at the 3-month time point and phthisis development at the most recent follow-up available.
Results :
Fifty eyes met inclusion criteria. 7 (14%) had a funnel RD; 14 (28%) had history of ocular trauma; 34 (68%) had a retinectomy, 19 (38%) used 5,000 centistoke SO, and 12 (24%) used PFO. Mean follow-up time was 10.9 ± 6.9 months. At 3 months, vision had remained stable or improved for 64% of eyes and the macula was attached for 66% of eyes. Mean pre-operative VA was 2.5 ± 0.5 logMAR and the mean VA at 3 months was 2.4 ± 0.7 logMAR with no statistically significant difference (p = 0.30). With multivariate regression, pre-operative VA was a statistically significantly predictive factor of post-operative VA at 3 months. Nine (18%) of eyes developed phthisis a mean of 11.4 ± 5.1 months after UCRD repair.
Conclusions :
Little is known about visual outcomes of retinal detachment surgeries for the most advanced retinal pathology because these are often deemed inoperable. This study examines the visual and anatomical outcomes for ultra-complex retinal detachments (UCRD). Although there was not a statistically significant improvement in vision observed for this cohort, the majority of patients achieved stable vision with anatomical success which may prevent the development of phthisis and improve the quality of life for the patient long-term. Further study is warranted.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.