Date Published: July 3, 2019
Publisher: Public Library of Science
Author(s): Misato Kobayashi, Takeshi Iwase, Kentaro Yamamoto, Eimei Ra, Norifumi Hirata, Hiroko Terasaki, Demetrios G. Vavvas.
To determine the influence of residual submacular fluid (SMF) on the recovery of function and structure of the retina after successful rhegmatogenous retinal detachment (RRD) reattachment.
We reviewed the medical records of all patients who had undergone successful RRD repair by scleral buckling (SB) surgery or by pars plana vitrectomy (PPV) from March 2011 to August 2014. Spectral-domain optical coherence tomographic images of the macular regions were used at 1, 2, 3, 6, 9, and 12 months following the surgery. The best-corrected visual acuities (BCVA) were evaluated at the same times.
The eyes with a macula-off RRD that were treated by SB surgery had a significant higher incidence of residual SMF (52%) than those treated by PPV (6.8%; P <0.001). Nevertheless, the postoperative BCVA was significantly improved in the eyes that had undergone SB surgery (P = 0.007). The postoperative BCVAs were not significantly different between the groups in which the SMF was absorbed (12 eyes) and not absorbed (13 eyes) within 1 month after the SB surgery. The photoreceptor outer segment length and the presence of a foveal bulge were not significantly different between these two groups at 12 months. Multiple regression analyses showed that the presence of a foveal bulge (β = 0.531, P = 0.001) and the duration of the retinal detachment before surgery (β = 0.465, P = 0.002) but not the duration of the SMF were independent factors significantly correlated with the final BCVA. These results suggest that the postoperative residual SMF does not significantly disrupt the functional and structural recovery of eyes with macula-off RRD treated by SB surgery.
A rhegmatogenous retinal detachment (RRD) is a common cause of visual impairments, and the main treatment for a RRD is a surgical reattachment of the retina . There are several types of retinal reattachment surgery, e.g., scleral buckling (SB), pneumatic retinopexy, and pars plana vitrectomy (PPV) combined with or without SB surgery . The choice of which patients will benefit from SB or PPV for the primary RRD repair is generally decided by the preoperative findings and the surgeons’ preferences .
A significantly higher number of eyes with residual SMF was observed in the macula-off RRD treated by SB surgery than in eyes treated by PPV. There was no significant difference in any factors including the final BCVA between the persistent SMF group and the rapid SMF resolution group. The multivariate regression analyses showed that presence of a foveal bulge and the duration of the retinal detachment before surgery, but not the duration of the residual SMF, were independent factors significantly correlated with the final BCVA.