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Rachel Israilevich, Matthew Starr, Vishal Swaminathan, Mirataollah Salabati, Raziyeh Mahmoudzadeh, Michael Ammar, Luv Patel, Jason Hsu; Good Visual Acuity Outcomes Following Retinectomy During Repair of Retinal Detachment with Proliferative Vitreoretinopathy. Invest. Ophthalmol. Vis. Sci. 2021;62(8):3632.
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© ARVO (1962-2015); The Authors (2016-present)
To investigate pre- and intra-operative metrics associated with good visual acuity (VA) following retinal detachment (RD) repair for proliferative vitreoretinopathy (PVR) that included relaxing retinectomy at time of surgery.
This was a single-institution, retrospective study evaluating all patients (pts) undergoing retinectomy during repair of RD with PVR from 1/1/2015-12/31/2019 with a final VA of 20/70 or better.
Of 3,789 pts undergoing RD surgery during the study period, only 57 underwent retinectomy at time of RD surgery and had a final VA of 20/70 or better. 16 pts were female (28%) and the mean age was 61.8 ± 10.5 years. The mean time from diagnosis to initial surgery was 2.1 ± 1.1 days. The mean initial RD size was 160 ± 60 degrees. 22 eyes (39%) were macula on at time of initial diagnosis. Only 7 eyes’ (12%) macula never detached during the study period. The mean pre- and post-operative logMAR VA was 0.93 ± 0.85 and 0.33 ± 0.16 respectively. The mean number of surgeries was 2.4 ± 0.9. The average retinectomy size was 151 ± 12.1 degrees. 14 eyes (25%) had a scleral buckle (SB) placed at initial surgery (Table 1). There was no difference in mean number of surgeries in eyes with a SB placed at initial surgery compared to those that did not (2.1 ± 0.6 vs 2.4 ± 1.0, p = 0.28), or in mean final VA (0.28 ± 0.16 vs 0.34 ± 0.17, p = 0.20). 16 eyes (28%) had primary PVR, of which 7 eyes (44%) had primary retinectomy (Table 2). Significantly fewer surgeries were required in these 7 eyes compared to the 9 eyes not undergoing primary retinectomy for initial RD with baseline PVR (1 ± 0.0 vs 2.3 ± 0.7, p = 0.0002), but no difference in final VA was seen (0.33 ± 0.16 vs 0.39 ± 0.11, p = 0.52). The mean time from recurrent RD diagnosis to surgery was 2.5 ±1.2 days, with no difference in time to surgery for recurrent RDs in eyes with macula on versus off RDs (3.1 ± 2.4 vs 2.3 ± 1.4 days, p=0.12, Table 2). 2 eyes (3.5%) had silicone oil tamponade at the final visit.
Eyes undergoing primary or secondary retinectomy during repair of RD with PVR can still achieve good VA. Macula status and time to surgery may be important factors in determining visual outcomes.
This is a 2021 ARVO Annual Meeting abstract.
Table 1: Type of repair for each RD surgery in eyes maintaining VA of 20/70 or better.
Table 2: Surgical techniques and RD characteristics of eyes undergoing retinectomy that maintained good VA.
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