Regional EuroTimes
Date Posted 17/05/2009
Re-attachment not only success criteria of retinal detachment surgery
Re-attachment not only success criteria of retinal detachment surgery
Success in re-attaching retinas does not always correlate with good visual outcomes, according to the findings from a large case series presented at the 9th EURETINA Congress, by Enrique Rodriguez de la Rúa, Hospital Clinico Universitario, Valladolid, Spain.
“Although there are multiples studies regarding the anatomical results of retinal detachment surgery there are few series providing functional outcomes after reattachment and most of these are from a single centre with just a few surgeons the purpose of our study is to provide details of the functional outcomes from a large series of primary rhegmatagenous retinal detachments that were successfully repaired,” said Dr Rodriguez De la Rúa.
The prospective, multicentre, case-series study, called Retina 1 Project involved 1080 cases of retinal detachment, with no preoperative proliferative vitreoretinopathy (PVR) or PVR of a grade less than C1. All underwent retinal re-attachment surgery between 2002 and 2008. The study’s investigators only included cases with final reattachment after three months of follow up in their final analysis. 83 clinical variables of each case were recorded.
In 955 cases retinal reattachment was achieved. However, final visual vision was registered only in 932 cases. Among those cases, final visual acuity was worse than 20/100 in 190 patients (20.4 %), between 20/40 and 20/100 in 346 cases (37.1 %) and 20/40 or better in 396 (42.5 %).
Among the factors which correlated with poor visual outcomes, the most relevant were detached macula (p<0.001), myopia greater than -5.0 D (p=0.17), previous failed attempts of reattachment (p=0.027), and age of more than 60 years (p<0.01), and total retinal detachment (p<0.01). In addition, patients who underwent scleral buckling generally had better vision than those who underwent vitrectomy (p<0.01).
“A significant percentage of cases after a successful repair of a RD have important visual sequels. We have to change the mentality from simply re-attaching the retina to also improving our knowledge of what is happening in the retinal cells and how we can stop the damage,” Dr Rodriguez De la Rúa concluded.
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