Hazelwood James E, Mitry Danny, Singh Jaswinder, Bennett Harry G B, Khan Ashraf A, Goudie Colin R
Princess Alexandra Eye Pavilion, Chalmers St, Edinburgh, EH3 9HA, UK.
The University of Edinburgh, Edinburgh, UK.
Eye (Lond). 2025 May;39(7):1318-1321. doi: 10.1038/s41433-025-03613-8. Epub 2025 Jan 24.
To address the paucity of long-term data on outcomes following rhegmatogenous retinal detachment (RRD) repair we aimed to establish the 10-year best corrected visual acuity (BCVA), redetachment rate and lens status for patients from the Scottish Retinal Detachment Study.
Data from patients who presented with RRD during the original study were collected from clinical records 10 years after repair. Patients were excluded if lacking 10 year follow-up data, and excluded from visual acuity analysis in the case of significant co-morbid ophthalmic disease.
103 patients had BCVA outcomes for at least 10 years post-operatively and met the inclusion criteria. 57 were macula-on and 46 were macula-off. Median10-year BCVA was 0.1 (IQR 0.3) logMAR (6/7.5). 10-year BCVA was significantly better in macula-on patients, compared to macula-off (-0.18 logMAR (p < 0.001)). There was a significant improvement in macula-off BCVA from short-term follow-up to 10-year BCVA (-0.26 logMAR, p = 0.04). 93% of macula-on patients achieved BCVA sufficient for UK driving standard compared to 65% of macula-off. There was no difference in 10-year BCVA between repair techniques. Thirty-four patients were phakic at follow-up, 65 pseudophakic, and 4 aphakic. Redetachment occurred in 14% and conferred a poorer 10-year BCVA (logMAR 0.3 IQR 0.78 (6/12)).
Long-term BCVA remains excellent following successful macula-on RRD repair with almost all macula-on, and most macula-off patients achieving the UK visual acuity driving standard. We demonstrate that macula-on detachments have significantly greater long long-term visual acuity than macula-off detachments, and that re-detachment is uncommon but confers a poorer long term visual outcome. This study provides objective long-term data to guide patient and surgeon expectations following retinal detachment repair.
为解决孔源性视网膜脱离(RRD)修复术后长期预后数据匮乏的问题,我们旨在确定来自苏格兰视网膜脱离研究的患者的10年最佳矫正视力(BCVA)、视网膜再脱离率和晶状体状态。
在原始研究期间出现RRD的患者的数据在修复术后10年从临床记录中收集。如果缺乏10年随访数据则将患者排除,若存在严重的合并眼科疾病则将其排除在视力分析之外。
103例患者术后至少10年有BCVA结果且符合纳入标准。57例黄斑在位,46例黄斑脱离。10年BCVA中位数为0.1(四分位间距0.3)logMAR(6/7.5)。与黄斑脱离患者相比,黄斑在位患者的10年BCVA明显更好(相差-0.18 logMAR,p < 0.001)。黄斑脱离患者从短期随访到10年随访时BCVA有显著改善(相差-0.26 logMAR,p = 0.04)。93%的黄斑在位患者达到了英国驾驶标准所需的BCVA,而黄斑脱离患者为65%。修复技术之间的10年BCVA没有差异。随访时34例患者晶状体在位,65例人工晶状体眼,4例无晶状体眼。视网膜再脱离发生率为14%,且10年BCVA较差(logMAR为 0.3,四分位间距0.78(6/12))。
成功修复黄斑在位的RRD后,长期BCVA仍然良好,几乎所有黄斑在位以及大多数黄斑脱离患者都达到了英国视力驾驶标准。我们证明黄斑在位的视网膜脱离患者长期视力明显优于黄斑脱离患者,并且视网膜再脱离不常见,但会导致较差的长期视力结果。本研究提供了客观的长期数据,以指导视网膜脱离修复术后患者和外科医生的预期。