Conventional retinal reattachment surgery.

Jan Sanaullah, Iqbal Arshad, Saeed Nasir, Ishaq Anjum, Khan Mohammad Daud

Eye Unit, Hayatabad Medical Complex, Khyber Institute of Ophthalmic Medical Sciences, Peshawar.

J Coll Physicians Surg Pak. 2004 Aug;14(8):470-3.

OBJECTIVE

To evaluate the surgical outcome in rhegmatogenous retinal detachment (RRD) cases operated by conventional retinal reattachment techniques.

DESIGN

Descriptive study.

PLACE AND DURATION OF STUDY

This study was conducted at Eye Unit, Hayatabad Medical Complex (HMC), KIOMS, Peshawar, from July, 2002 to December, 2002.

MATERIALS AND METHODS

A retrospective analysis of ophthalmic record of rhegmatogenous retinal detachment operated by conventional retinal reattachment surgery was done. Anatomic outcome was evaluated in relation to duration of presentation and pre-operative proliferative vitreoretinopathy (PVR). Postoperative visual acuity (VA) was compared to pre-operative VA. Complications and causes of failure of anatomic success were also analyzed.

RESULTS

A total of 40 cases were studied. Male to female ratio was approx 2:1. Retinal breaks were localized in 70% cases, 37.5 % cases had single break while 32.5 % cases had more than one retinal breaks. Forty two percent had total retinal detachment while 57.5 % had less than total retinal detachment. Five percent had attached macula at presentation. Immediate postoperative retinal reattachment was attained in 80% cases but ultimate anatomic success after at least 6 months of follow up was 72.5%. Patients who presented earlier (upto 1 year) had 75% anatomic success while those who presented later than 1 year had 50% success rate. Postoperative visual improvement was noted in 80 % cases with flat macula, 65% had VA 6/60 or better after surgery. Most common cause of failure of anatomical reattachment was PVR (63.63% of failed conventional surgery). Most common postoperative complication was raised intraocular pressure ( > 21 mmHg) in 25 cases.

CONCLUSION

There is more chance of retinal reattachment and visual restoration in cases that present earlier. PVR is the main cause of failure of conventional retinal reattachment surgery. Postoperative visual improvement is directly related to surgical reattachment of the macula.