Korean J Ophthalmol.  2022 Dec;36(6):477-485. 10.3341/kjo.2022.0057.

Preoperative and Postoperative Factors Affecting Functional Success in Anatomically Successful Retinal Detachment Surgery

• Guner ME
• Guner MK
• Cebeci Z
• Kır N

• KMID: 2536636
• DOI: http://doi.org/10.3341/kjo.2022.0057

Abstract

Purpose
To investigate preoperative and postoperative factors affecting functional success in anatomically successful retinal detachment surgery.
Methods
Seventy-five eyes of 75 patients with rhegmatogenous retinal detachment who underwent anatomically successful surgery from 2014 to 2019 with more than 1 year follow-up were included in the study. Demographic characteristics, ocular examination findings, preoperative and postoperative spectral domain optic coherence tomography images were retrospectively evaluated.
Results
The mean age was 53.9 ± 17 years (range, 11–85 years). The mean follow-up period was 36.7 ± 16 months (range, 14–72 months). The mean best-corrected visual acuity of the patients before surgery was 1.35 ± 1.24 and at postoperative 12 months was 0.66 ± 0.5 logarithm of the minimum angle of resolution. Patients who were operated in 7 days of visual symptoms onset were found to have better visual acuity at the first and subsequent postoperative exams. Preoperative proliferative vitreoretinopathy, vitreous hemorrhage, and extent of retinal detachment were found to have a negative effect on functional success at 12 months. Regeneration of the outer retinal layers had a positive effect on visual acuity at 12 months but did not significantly increase visual acuity after 12 months. Multivariate analysis showed that preoperative external limiting membrane integrity was significantly associated with better functional outcomes.
Conclusions
Early intervention, presence of preoperative external limiting membrane integrity, and restoration of postoperative outer retinal layers positively affected functional success. The presence of preoperative vitreous hemorrhage, preoperative proliferative vitreoretinopathy, and the extent of retinal detachment had a negative effect on prognosis at 12 months.

Keyword

Optical coherence tomography; Retinal detachment; Retinal pigment epithelium; Vitrectomy