[Macular fibrosis after surgery of retinal detachment].

PURPOSE

To report the prevalence and visual outcome of macular pucker occurring after retinal detachment surgery, and to analyze its risk factors.

METHODS

We retrospectively studied 865 cases of retinal detachment that had been successfully treated in the absence of macular hole or proliferative vitreoretinopathy higher than grade C1. For the statistical analysis, 63 variables were submitted to CHI-square test.

RESULTS

Macular pucker occurred in 68 cases (7.7%). Final visual acuity was 0.5 or better in 24 cases, spontaneously in 7 and after macular surgery in 17. In 6 other cases, macular pucker was much less important in terms of visual impairment than coexisting amblyopia or other posterior pole pathology. In the 38 remaining cases, macular pucker was the cause of visual failure, despite macular surgery in 9 of them. Retinal detachment recurred after macular surgery in 2/26 cases. Nine variables were found to correlate with an increased risk of macular pucker: emmetropia, hyperopia, preoperative acuity reduced to light perception-hand movement, macula off, preoperative proliferative vitreoretinopathy (grade B or C1), retinal tears up to 30 degrees, retinal tears larger than 30 degrees, and cumulative retinal break area larger than 3 disks.

CONCLUSION

Our results show that macular surgery can be useful in case of macular pucker after retinal detachment surgery. They also suggest that macular pucker and proliferative vitreoretinopathy have some risk factors in common.