Elsevier

Ophthalmology

Volume 105, Issue 11, 1 November 1998, Pages 2149-2153
Ophthalmology

Visual recovery in macula-off rhegmatogenous retinal detachments

https://doi.org/10.1016/S0161-6420(98)91142-3Get rights and content

Abstract

Objective

This study aimed to review the best postoperative visual recovery in patients with macula-off detachments of 7 days’ duration or less.

Design

Noncontrolled, prospective, interventional case series.

Participants

A total of 104 patients with macula-off detachments of 7 days or less were studied, and the time of the macular detachment within the first 7 days was carefully determined.

Intervention

All 104 detachments were repaired with a primary scleral buckling procedure. Four cases were primary failures and were excluded from the study.

Main outcome measures

Statistical methods were used to compare the visual results of three groups of patients; those operated on between 1 and 2 days, 3 and 4 days, or 5 and 7 days after macular involvement.

Results

The mean postoperative visual acuity was 20/60. Fifty-nine percent of patients regained 20/50 or better visual acuity, 35% regained visual acuity between 20/60 and 20/200, and 5% of patients were left with visual acuity of less than 20/200 regardless of whether they had undergone surgery within 1 to 2 days, 3 to 4 days, or 5 to 7 days after macular involvement. There was no statistical difference in visual recovery in patients operated on within 1 to 2 days, 3 to 4 days, or 5 to 7 days after macular involvement (P = 0.533).

Conclusion

Within the first week after development of macula-off retinal detachment, delay in surgical repair does not adversely affect visual outcome.

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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