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Fovea-sparing rhegmatogenous retinal detachments: impact of clinical factors including time to surgery on visual and anatomic outcomes

  • Irene T. Lee
  • Shaun I.R. Lampen
  • Tien P. Wong
  • James C. MajorJr
  • Charles C. WykoffEmail author
Retinal Disorders
  • 138 Downloads

Abstract

Purpose

Evaluate the impact of time to surgery and other clinical factors on visual and anatomic outcomes following surgical repair of fovea-sparing rhegmatogenous retinal detachments (RRD).

Methods

Visual and anatomic outcomes were analyzed for their association with clinical factors, including lens status, preoperative visual acuity (VA), contralateral RRD, RRD symptom duration, time to surgery, single-operation anatomic success, number of quadrants involved, posterior RRD extent, RRD extent closest to the fovea, number of retinal breaks, quadrants with retinal breaks, and surgery performed Saturday or Sunday versus Monday–Friday.

Results

Medical records of 423 eyes with fovea-sparing RRD repaired with pneumatic retinopexy (PR), scleral buckle (SB), pars plana vitrectomy (PPV), and PPV with SB (PPV/SB) were included. Sixty-seven percent and 89% were operated within 24 and 72 h of RRD presentation, respectively. Single-operation anatomic success rates were 59%, 89%, 84%, and 92% for PR, SB, PPV, and PPV/SB interventions, respectively. Final anatomic success was 100%. Three clinical factors correlated with faster time to surgery: shorter symptom duration (p < 0.02), RRD superior location (p = 0.001), and posterior extension into the macula (p = 0.01). The time to surgery did not correlate with visual or anatomic outcomes. Two clinical factors positively correlated with postoperative vision: preoperative VA (r > 0.25, p < 0.04) and single-operation anatomic success (p < 0.04). Surgeries performed on Monday through Friday (n = 411) were associated with better anatomic outcomes compared with the limited number performed on Saturday or Sunday (n = 12) (p = 0.005), although a greater proportion of operated cases over the weekend were PR.

Conclusions

In the context of the current series, time to surgery did not correlate with visual or anatomic outcomes following the surgical repair of fovea-sparing RRDs. Preoperative VA and single-operation anatomic success correlated with improved visual outcome.

Keywords

Retina Retinal detachment Vitreoretinal surgery 

Notes

Compliance with ethical standards

Conflicts of interest

All authors have completed the ICMJE uniform disclosure form at www.icmje.org/coi_disclosure.pdf and declare: CCW has received research grants from Adverum Biotechnologies, grants from Aerpio Therapeutics, grants and personal fees from Alcon Laboratories, Inc., grants from Aldeyra Therapeutics, Inc., grants from Alimera Sciences, Inc., grants from Allegro Ophthalmics, LLC, grants and personal fees from Allergan, Inc., personal fees from Alnylam Pharmaceuticals, grants from Apellis Pharmaceutical, personal fees from Atheneum Partners, grants from Astellas Pharma Inc., grants from Aura Biosciences, Inc., personal fees from Bayer AG, grants from Boehrigner-Ingelheim, grants from Chiltern International, Inc., personal fees from Consultants LLC, personal fees from CORCEPT, personal fees from Destum Partners Inc., personal fees from D.O.R.C., grants and personal fees from Genentech, Inc., grants from GlaxoSmithKline, grants from Heidelberg Engineering, personal fees from Hexal AG, grants from Iconic Therapeutics, grants from INC Research, grants from John Hopkins University, personal fees from k2c Medical Communications, grants from NEI, personal fees from Notal Vision, grants from Novartis International AG, personal fees from Novo Nordisk, grants from OHR Pharmaceutical, Inc., personal fees from ONL Therapeutics, Inc., grants from Ophthotech Corporation, grants from Ora, Inc., grants from pSivida Corp., grants and personal fees from Regeneron Pharmaceuticals, grants from Regenexbio Inc., grants and personal fees from Roche, grants and personal fees from Santen Inc., personal fees from Prime Education LLC, grants from SciFluor Life Sciences, LLC, personal fees from System Analytic, grants from Taiwan Liposome Company, personal fees from ThromboGenics NV., grants from Tyrogenex, Inc., personal fees from Valeant Pharmaceuticals International, Inc., grants and personal fees from Clearside Biomedical, outside the submitted work; JCM has received research grants and personal fees from Alimera, grants from Acucela, grants from Alcon, grants from Allergan, grants from Apellis, grants from Clearside Biomedical, grants from D.O.R.C., grants from DRCR.net, grants and personal fees from Genentech, grants from Iconic, grants from Novartis, grants from Ophthotech, grants from Roche, grants from Regeneron, grants from Bayer, grants from Santeen, grants from Thrombogenics, grants from Tyrogenex, outside the submitted work; TPW, ITL, and SIRL declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this retrospective type of study, formal consent is not required.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Retina Consultants of HoustonHoustonUSA
  2. 2.Icahn School of Medicine at Mount SinaiNew YorkUSA
  3. 3.Blanton Eye InstituteHouston Methodist Hospital & Weill Cornell Medical CollegeHoustonUSA

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