Visual recovery in macula-off rhegmatogenous retinal detachments
Section snippets
Patients and materials
In this prospective study, 303 consecutive patients with rhegmatogenous retinal detachments presenting over a 30-month period (August 1, 1994-January 31, 1997) to the authors were interviewed and examined to determine the status of macular attachment. The purpose of the study was to review the postoperative visual recovery of patients with macula-off detachments of 7 days’ duration or less. All patients were carefully interviewed to accurately classify the onset of macular detachment to a
Results
A total of 100 patients were found to have a primary rhegmatogenous detachment for which the patient could accurately determine the onset of macular detachment, and the detachment fulfilled the criteria outlined above. The mean age of the patients was 59.4 years (range, 16–88 years). The mean duration of macular detachment was 3.98 days (range, 1–7 days) (Fig 1).
The patients were divided into three groups by the number of days of macular detachment: 1 to 2 days of detachment (n = 30), 3 to 4
Discussion
With modern diagnostic and surgical techniques, a 90% or greater success rate of detachment repair is expected.2, 3, 4, 5, 6, 7, 8, 9, 10 In this series, 100 (96%) of 104 primary detachments were repaired successfully with initial surgery. Although anatomic success rates are high, functional improvement in vision once the macula is reattached remains disappointing. In previous studies, a return of central visual acuity of 20/50 or greater has ranged from 42% to 60%.5, 7, 11, 12, 13 The loss of
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Retinal detachment
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2023, Ophthalmology RetinaCitation Excerpt :Thus, this staging system can allow for the assessment of postoperative outcomes based on morphology at presentation and may potentially inform optimal timing for surgery based on presenting features. The somewhat outdated recommendation of performing surgery for fovea-off RRD within one week was based on limited evidence8 and is now being challenged by more recent work demonstrating that surgery within three days may result in better outcomes.10,11,12,13,14 However, the poor reliability of patient-reported symptoms of central vision loss presents a challenge that may be remedied by utilizing imaging as an objective assessment of baseline status. Based on our observations from multiple studies, we noted that ORCs in stage 3a and particularly in stage 3b occur when there have been significant structural changes to the outer retina from the progressive exposure to liquefied vitreous.
Impact of the Time to Surgery on Visual Outcomes for Rhegmatogenous Retinal Detachment Repair: A Meta-Analysis
2022, American Journal of Ophthalmology