Abstract
Objective
To identify risk factors affecting visual outcomes in successfully re-attached macula-off rhegmatogenous retinal detachment (RD) surgery.
Design
A prospective study, using online databases, of visual outcomes for 2074 macula-off retinal detachments that were successfully re-attached by vitrectomy and internal tamponade. The database included detailed retinal diagrams of each detachment.
Main outcome measure
The probability of achieving a post-operative visual acuity (VA) of ≤0.30 LogMAR (Snellen 6/12 or better).
Results
Male patients accounted for 64.9% of the sample and the median age was 63 years old. The median pre-operative VA was counting fingers (LogMAR 1.98); this improved to 0.41 LogMAR post-operatively. A post-operative VA of ≤0.30 LogMAR was achieved for 1012 (48.8%) eyes and the factors affecting this were the patient age and gender, pre-operative VA, duration of central vision loss, PVR grade, lens status, total RD and the presence of any ocular co-pathology where the model area under the receiver operator curve was 71.6%.
Conclusions
From the identified risk factors that decrease the probability of achieving a post-operative visual acuity of ≤0.30 LogMAR, the most important modifiable risk factor was the duration of central vision loss. Recent macula-off retinal detachments should be repaired within 72 h of the loss of central vision.
Similar content being viewed by others
Login or create a free account to read this content
Gain free access to this article, as well as selected content from this journal and more on nature.com
or
References
Thompson JA, Snead MP, Billington BM, Barrie T, Thompson JR, Sparrow JM. National audit of the outcome of primary surgery for rhegmatogenous retinal detachment. II. Clinical outcomes. Eye. 2002;16:771–7. http://www.ncbi.nlm.nih.gov/pubmed/12439675.
Wickham L, Ho-Yen GO, Bunce C, Wong D, Charteris DG. Surgical failure following primary retinal detachment surgery by vitrectomy: risk factors and functional outcomes. Br J Ophthalmol. 2011;95:1234–8. http://www.ncbi.nlm.nih.gov/pubmed/21156702.
Wickham L, Bunce C, Wong D, Charteris DG. Retinal detachment repair by vitrectomy: simplified formulae to estimate the risk of failure. Br J Ophthalmol. 2011;95:1239–44. http://www.ncbi.nlm.nih.gov/pubmed/21325394.
Mitry D, Awan MA, Borooah S, Rehman Siddiqui MA, Brogan K, Fleck BW, et al. Surgical outcome and risk stratification for primary retinal detachment repair: results from the Scottish Retinal Detachment study. Br J Ophthalmol. 2012;96:730–4.
Williamson TH, Lee EJK, Shunmugam M. Characteristics of rhegmatogenous retinal detachment and their relationship to success rates of surgery. Retina. 2014;34:1421–7. http://www.ncbi.nlm.nih.gov/pubmed/24480842.
Wilkinson CP. Mysteries regarding the surgically reattached retina. Trans Am Ophthalmol Soc. 2009;107:55–7. http://www.ncbi.nlm.nih.gov/pubmed/20126482.
Doyle E, Herbert EN, Bunce C, Williamson TH, Laidlaw DAH. How effective is macula-off retinal detachment surgery. Might good outcome be predicted?. Eye. 2007;21:534–40. http://www.nature.com/articles/6702260.
Williamson TH, Shunmugam M, Rodrigues I, Dogramaci M, Lee E. Characteristics of rhegmatogenous retinal detachment and their relationship to visual outcome. Eye. 2013;27:1063–9. http://www.ncbi.nlm.nih.gov/pubmed/23788207.
Lecleire-Collet A, Muraine M, Menard J-F, Brasseur G. Predictive visual outcome after macula-off retinal detachment surgery using optical coherence tomography. Retina. 2005;25:44–53. http://www.ncbi.nlm.nih.gov/pubmed/15655440.
Mowatt L, Tarin S, Nair RG, Menon J, Price NJ. Correlation of visual recovery with macular height in macula-off retinal detachments. Eye. 2010;24:323–7. http://www.nature.com/articles/eye200974.
van de Put MAJ, Croonen D, Nolte IM, Japing WJ, Hooymans JMM, Los LI. Postoperative recovery of visual function after macula-off rhegmatogenous retinal detachment. PLoS One. 2014;9:e99787. http://www.ncbi.nlm.nih.gov/pubmed/24927502.
Ross WH. Visual recovery after macula-off retinal detachment. Eye. 2002;16:440–6. http://www.nature.com/articles/6700192.
Abouzeid H, Wolfensberger TJ. Macular recovery after retinal detachment. Acta Ophthalmol Scand. 2006;84:597–605. http://doi.wiley.com/10.1111/j.1600-0420.2006.00676.x.
Liu F, Meyer CH, Mennel S, Hoerle S, Kroll P. Visual recovery after scleral buckling surgery in macula-off rhegmatogenous retinal detachment. Ophthalmologica. 2006;220:174–80. https://www.karger.com/Article/FullText/91761.
van Bussel EM, van der Valk R, Bijlsma WR, La Heij EC. Impact of duration of macula-off retinal detachment on visual outcome. Retina. 2014;34:1917–25. http://www.ncbi.nlm.nih.gov/pubmed/25121930.
Frings A, Markau N, Katz T, Stemplewitz B, Skevas C, Druchkiv V, et al. Visual recovery after retinal detachment with macula-off: is surgery within the first 72 h better than after? Br J Ophthalmol. 2016;100:1466–9. http://bjo.bmj.com/lookup/doi/10.1136/bjophthalmol-2015-308153.
Royal College of Ophthalmologists. Retinal detachment data set. R College Ophthalmol. 2010. https://www.rcophth.ac.uk/standards-publications-research/audit-and-data/clinical-data-sets/retinal-detachment-data-set/.
Mitry D, Singh J, Yorston D, Siddiqui MAR, Wright A, Fleck BW, et al. The predisposing pathology and clinical characteristics in the Scottish retinal detachment study. Ophthalmology. 2011;118:1429–34.
Ng H, La Heij EC, van Meurs JC. The duration of macular detachment in retinal detachment is difficult to determine. Acta Ophthalmol. 2019. https://www.ncbi.nlm.nih.gov/pubmed/31693277.
Madgula IM, Costen M. Functional outcome and patient preferences following combined phaco-vitrectomy for macular hole without prone posturing. Eye. 2008;22:1050–3. http://www.ncbi.nlm.nih.gov/pubmed/17435683.
Yorston D, Siddiqui MAR, Awan MA, Walker S, Bunce C, Bainbridge JW. Pilot randomised controlled trial of face-down posturing following phacovitrectomy for macular hole. Eye. 2012;26:267–71.
Fajgenbaum MAP, Neffendorf JE, Wong RS, Laidlaw DAH, Williamson TH. Intraoperative and postoperative complications in phacovitrectomy for epiretinal membrane and macular hole. Retina. 2018;38:1865–72. http://www.ncbi.nlm.nih.gov/pubmed/29324594.
Sullivan PM, Luff AJ, Aylward GW. Results of primary retinal reattachment surgery: a prospective audit. Eye. 1997;11:869–71. http://www.ncbi.nlm.nih.gov/pubmed/9537149.
Ross WH. Visual recovery after macula-off retinal detachment. Eye. 2002;16:440–6. http://www.ncbi.nlm.nih.gov/pubmed/12101451.
Mitry D, Awan MAMA, Borooah S, Syrogiannis A, Lim-Fat C, Campbell H, et al. Long-term visual acuity and the duration of macular detachment: findings from a prospective population-based study. Br J Ophthalmol. 2013;97:149–52. http://www.ncbi.nlm.nih.gov/pubmed/23159447.
Acknowledgements
It is with deep regret that we note the death of our friend and colleague Robert Johnston, who sadly died in September 2016. Without his inspirational vision, determination and career long commitment to quality improvement in ophthalmology this work would not have been possible.
Members of the BEAVRS Retinal Detachment Outcomes Group
A.G. Casswell9, Andrew H.C. Morris10, Assad Jalil11, Atiq R. Babar12, Craig Goldsmith13, David Steel14, Diego Sanchez-Chicharro15, Ed Hughes9, E.N. Herbert16, Huw Jenkins17, Imran J. Khan18, John D. Ellis19, Jonathan Smith14, Kamaljit S. Balaggan20, Kurt Spiteri Cornish21, Laura Wakeley22, Mark Costen12, Sonali Tarafdar19, Stephen J. Charles11, Stephen Winder21, Timothy Cochrane23, Tsveta Ivanova11, Vasileios T. Papastavrou24, Vaughan Tanner25.
Funding
The database set up and running has been made possible by funding support from the British and Eire Association of Vitreoretinal Surgeons, and Euretina.
Author information
Authors and Affiliations
Consortia
Corresponding author
Ethics declarations
Conflict of interest
The authors declare that they have no conflict of interest.
Additional information
Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Members of the BEAVRS Retinal Detachment Outcomes Group are listed below Acknowledgements.
Supplementary information
Rights and permissions
About this article
Cite this article
Yorston, D., Donachie, P.H.J., Laidlaw, D.A. et al. Factors affecting visual recovery after successful repair of macula-off retinal detachments: findings from a large prospective UK cohort study. Eye 35, 1431–1439 (2021). https://doi.org/10.1038/s41433-020-1021-y
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1038/s41433-020-1021-y
This article is cited by
-
The Scottish Retinal Detachment Study: 10-year outcomes after retinal detachment repair
Eye (2025)
-
Predicting post-surgery change in visual acuity after successful repair of macula-off retinal detachments: findings from a large prospective UK cohort study
Eye (2025)
-
A review of rhegmatogenous retinal detachment: past, present and future
Wiener Medizinische Wochenschrift (2025)
-
Pneumatic retinopexy for primary rhegmatogenous retinal detachment: from a clinical trial to the real-life experience
BMC Ophthalmology (2024)
-
Correlation between multifocal electroretinogram and optical coherence tomography findings with visual acuity after vitrectomy surgery for retinal detachment: an observational study
International Journal of Retina and Vitreous (2024)
