Abstract
Purpose :
To report the clinical presentation and outcomes of surgery in patients with retinal detachment secondary to retinal dialysis.
Methods :
Retrospective case series of patients undergoing surgery for retinal detachment secondary to retinal dialysis between January 1, 2012 and December 31, 2021. Patients with ruptured globe injury and giant retinal tears were excluded. All patients had at least 2 months of follow-up.
Results :
The study included 81 eyes of 79 patients with a mean age of 29.1 (SD, 15.1) years. Sixty-three (77.8%) eyes were from male patients. Forty-five (57.7%) cases were associated with trauma. Mean preoperative best-corrected visual acuity (BCVA) was 20/187 (range: 20/15 to light perception). Forty (53.3%) patients had a macula-involving retinal detachment. Primary scleral buckling (SB) was performed in 50 (61.7%) eyes, combined SB and pars plana vitrectomy (PPV) in 25 (30.9%) eyes, and primary PPV in 6 (7.4%) eyes. The rate of retinal reattachment at 6 months was 77.9% and did not differ between treatment groups (P > 0.05). Mean BCVA of eyes with retinal attachment at last follow-up (N = 75) was 20/85. Preoperative BCVA correlated with BCVA at last follow-up visit (r = 0.642; P < 0.001). Mean BCVA at last follow-up exam in patients who received primary SB was 20/47 compared to 20/796 in those who received primary PPV (P < 0.001) and 20/250 in those who received combined SB/PPV (P = 0.001). Best-corrected visual acuity was 20/40 or better in 60% of patients who underwent SB compared to 33.3% of patients who underwent primary PPV (P > 0.05) and 16.0% of patients who underwent combined SB/PPV (P = 0.001). Additionally, BCVA at last follow-up was 20/200 or worse in 18.0% of patients who underwent primary SB compared to 66.7% of patients who underwent primary PPV (P = 0.02) and 44.0% of patients who underwent combined SB/PPV (P = 0.049). Fifteen (18.8%) patients required an additional operation for retinal redetachment, the proportion of which did not differ between treatment groups (P > 0.05).
Conclusions :
Retinal dialysis is typically associated with trauma and frequently occurs in young male patients. Postoperative visual outcomes are generally associated with preoperative visual function. Primary SB is an effective treatment strategy for patients with retinal dialysis who do not require PPV for other concomitant traumatic or non-traumatic ocular pathology.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.