Rhegmatogenous retinal detachments: primary reattachment rates and visual outcomes over a 4-year period

Ir J Med Sci. 2020 Feb;189(1):355-363. doi: 10.1007/s11845-019-02084-7. Epub 2019 Aug 15.

Abstract

Background and aims: To describe rhegmatogenous retinal detachment surgery in a Dublin tertiary referral centre over a 4-year period and to examine factors predictive of surgical and anatomical success.

Methods: A retrospective study was performed by reviewing the surgical log and the charts of patients who underwent a primary retinal detachment repair in a specialist centre over a 4-year period between 2012 and 2015. We excluded exudative and tractional cases. Multiple parameters were recorded including macular status, visual acuity, type of procedure, complications and visual and anatomical outcomes at 6 months post operation. Primary reattachment rate was calculated alongside change in visual acuity. Chi-square testing and analysis of variance were utilized to determine the effect which lens status, macular status, extent of breaks and type of procedure had on outcome and visual success.

Results: A total of 613 primary rhegmatogenous retinal detachment repairs were performed over the 4-year period. Our primary reattachment rate was calculated to be 88.58% (annual range 85.25-91.30%) with a perioperative complication rate of 2.94%. We noted a statistical significant improvement in VA with a median logMAR VA of 1.0 at presentation to 0.5 at 6 months post procedure. Macular status (chi-square test p = 0.15, X2 = 2.072) and lens status (chi-square test p = 0.2974, X2 = 1.086) had no statistical effect on the final anatomical outcome. However, eyes with giant retinal tears were more likely to redetach than those without (chi-square test p = 0.0069, X2 = 7.3). There was no statistical significant difference in the proportion of eyes achieving visual success by surgery category (one-way ANOVA analysis p = 0.501).

Conclusions: This is the first study of its kind in Ireland and will help surgeons benchmark their results against international standards in the future. Accurate recording of logMAR acuity and intraoperative complications is imperative to assist with prospective studies.

Keywords: Complications; Procedure type; Retinal detachments; Rhegmatogenous; Success rate; Visual success.

MeSH terms

  • Aged
  • Female
  • Humans
  • Male
  • Retinal Detachment / diagnosis*
  • Retinal Detachment / pathology
  • Retinal Detachment / surgery*
  • Retrospective Studies
  • Time Factors
  • Treatment Outcome
  • Visual Acuity / genetics*