Predictors for recovery of macular function after surgery for primary macula-off rhegmatogenous retinal detachment

  • Matthew Geiger
  • Jesse M. SmithEmail author
  • Anne Lynch
  • Jennifer L. Patnaik
  • Scott C. N. Oliver
  • James A. Dixon
  • Naresh Mandava
  • Alan G. Palestine
  • The University of Colorado Retina Research Group
Original Paper



To determine predictors of best-corrected postoperative visual acuity (VA) in patients who underwent surgical intervention for macula-off rhegmatogenous retinal detachment.

Materials and methods

Primary macula-off retinal detachments from the University of Colorado Primary Rhegmatogenous Retinal Detachment Database (2012–2017) were reviewed. The primary outcome measure was a postoperative VA of 20/40 or better at least 6 months after surgery. Patient demographics, medical history, duration of central vision loss before surgery, examination findings, operative technique, and postoperative findings were analyzed as possible predictors of postoperative visual recovery to 20/40 or better. Chi-square or Fisher’s exact test was used to compare categorical variables, and Wilcoxon rank sum test was used for continuous variables. A multivariable logistic regression analysis was used to determine the adjusted odds ratios and 95% confidence intervals for variables that were significant in the univariable analyses. Statistical significance was set at p < 0.05.


One hundred thirty-one patients met inclusion criteria. Eighty-one (61.8%) patients achieved a postoperative VA of 20/40 or better 6 or more months after surgery. Patients with a single retinal break were more likely than patients with more than one break to reach a postoperative VA of 20/40 or better (76.9% vs. 55.4%, p = 0.021). Patients with a better preoperative logMAR VA had better postoperative VA (p = 0.021). Duration of central vision loss prior to surgical repair was not related to final postoperative VA in this particular study.


Postoperative recovery of visual acuity to 20/40 or better was significantly more common in patients with a single retinal break as well as in patients with better preoperative visual acuity. Duration of central vision loss prior to surgical repair was not significantly associated with postoperative VA.


Primary macula-off Rhegmatogenous retinal detachment Pars plana vitrectomy Scleral buckle Functional retina recovery 



The University of Colorado Retina Research Group: Marc T. Mathias, MD, Frank S. Siringo, MD, Paula E. Pecen, MD, Jeffery L. Olson, MD, James S. Snitzer, BS.


Support from a Challenge Grant to the Department of Ophthalmology from Research to Prevent Blindness, Inc.

Compliance with ethical standards

Conflict of interest

All authors declare that they have no conflict of interest.


  1. 1.
    D’Amico DJ (2008) Clinical practice. Primary retinal detachment. N Engl J Med 359(22):2346–2354. CrossRefPubMedGoogle Scholar
  2. 2.
    Mitry D, Charteris DG, Fleck BW, Campbell H, Singh J (2010) The epidemiology of rhegmatogenous retinal detachment: geographical variation and clinical associations. Br J Ophthalmol 94(6):678–684. CrossRefPubMedGoogle Scholar
  3. 3.
    Mitry D, Fleck BW, Wright AF, Campbell H, Charteris DG (2010) Pathogenesis of rhegmatogenous retinal detachment: predisposing anatomy and cell biology. Retina 30(10):1561–1572. CrossRefPubMedGoogle Scholar
  4. 4.
    Wilkes SR, Beard CM, Kurland LT, Robertson DM, O’Fallon WM (1982) The incidence of retinal detachment in Rochester, Minnesota, 1970–1978. Am J Ophthalmol 94(5):670–673CrossRefGoogle Scholar
  5. 5.
    Van de Put MA, Hooymans JM, Los LI (2013) The incidence of rhegmatogenous retinal detachment in The Netherlands. Ophthalmology 120(3):616–622. CrossRefPubMedGoogle Scholar
  6. 6.
    Doyle E, Herbert EN, Bunce C, Williamson TH, Laidlaw DA (2007) How effective is macula-off retinal detachment surgery. Might good outcome be predicted? Eye (London, England) 21(4):534–540. CrossRefGoogle Scholar
  7. 7.
    Ross WH (2002) Visual recovery after macula-off retinal detachment. Eye (London, England) 16(4):440–446. CrossRefGoogle Scholar
  8. 8.
    Thelen U, Amler S, Osada N, Gerding H (2012) Outcome of surgery after macula-off retinal detachment—results from MUSTARD, one of the largest databases on buckling surgery in Europe. Acta Ophthalmol 90(5):481–486. CrossRefPubMedGoogle Scholar
  9. 9.
    Hassan TS, Sarrafizadeh R, Ruby AJ, Garretson BR, Kuczynski B, Williams GA (2002) The effect of duration of macular detachment on results after the scleral buckle repair of primary, macula-off retinal detachments. Ophthalmology 109(1):146–152CrossRefGoogle Scholar
  10. 10.
    Lecleire-Collet A, Muraine M, Ménard J-F, Brasseur G (2006) Evaluation of macular changes before and after successful retinal detachment surgery using stratus-optical coherence tomography. Am J Ophthalmol 142(1):176–179. CrossRefPubMedGoogle Scholar
  11. 11.
    Burton TC (1982) Recovery of visual acuity after retinal detachment involving the macula. Trans Am Ophthalmol Soc 80:475–497PubMedPubMedCentralGoogle Scholar
  12. 12.
    Tani P, Robertson DM, Langworthy A (1981) Prognosis for central vision and anatomic reattachment in rhegmatogenous retinal detachment with macula detached. Am J Ophthalmol 92(5):611–620CrossRefGoogle Scholar
  13. 13.
    van de Put MA, Croonen D, Nolte IM, Japing WJ, Hooymans JM, Los LI (2014) Postoperative recovery of visual function after macula-off rhegmatogenous retinal detachment. PLoS ONE 9(6):e99787. CrossRefPubMedPubMedCentralGoogle Scholar
  14. 14.
    Frings A, Markau N, Katz T, Stemplewitz B, Skevas C, Druchkiv V, Wagenfeld L (2016) Visual recovery after retinal detachment with macula-off: is surgery within the first 72 h better than after? Br J Ophthalmol 100(11):1466–1469. CrossRefPubMedGoogle Scholar
  15. 15.
    Park DH, Choi KS, Sun HJ, Lee SJ (2018) Factors associated with visual outcome after macula-off rhegmatogenous retinal detachment surgery. Retina (Philadelphia, Pa) 38(1):137–147. CrossRefGoogle Scholar
  16. 16.
    van Bussel EM, van der Valk R, Bijlsma WR, La Heij EC (2014) Impact of duration of macula-off retinal detachment on visual outcome: a systematic review and meta-analysis of literature. Retina (Philadelphia, Pa) 34(10):1917–1925. CrossRefGoogle Scholar
  17. 17.
    Ross WH, Kozy DW (1998) Visual recovery in macula-off rhegmatogenous retinal detachments. Ophthalmology 105(11):2149–2153. CrossRefPubMedGoogle Scholar
  18. 18.
    Liu F, Meyer CH, Mennel S, Hoerle S, Kroll P (2006) Visual recovery after scleral buckling surgery in macula-off rhegmatogenous retinal detachment. Ophthalmologica Journal International d’ophtalmologie International Journal of Ophthalmology Zeitschrift fur Augenheilkunde 220(3):174–180. CrossRefPubMedGoogle Scholar
  19. 19.
    Salicone A, Smiddy WE, Venkatraman A, Feuer W (2006) Visual recovery after scleral buckling procedure for retinal detachment. Ophthalmology 113(10):1734–1742. CrossRefPubMedGoogle Scholar
  20. 20.
    Kim JD, Pham HH, Lai MM, Josephson JW, Minarcik JR, Von Fricken M (2013) Effect of symptom duration on outcomes following vitrectomy repair of primary macula-off retinal detachments. Retina (Philadelphia, Pa) 33(9):1931–1937. CrossRefGoogle Scholar
  21. 21.
    Ross W, Lavina A, Russell M, Maberley D (2005) The correlation between height of macular detachment and visual outcome in macula-off retinal detachments of < or = 7 days’ duration. Ophthalmology 112(7):1213–1217. CrossRefPubMedGoogle Scholar
  22. 22.
    Greven MA, Leng T, Silva RA, Leung L-SB, Karth PA, Moshfeghi DM, Sanislo SR, Schachar IH (2018) Reductions in final visual acuity occur even within the first 3 days after a macula-off retinal detachment. Br J Ophthalmol. CrossRefPubMedGoogle Scholar
  23. 23.
    Diederen RM, La Heij EC, Kessels AG, Goezinne F, Liem AT, Hendrikse F (2007) Scleral buckling surgery after macula-off retinal detachment: worse visual outcome after more than 6 days. Ophthalmology 114(4):705–709. CrossRefPubMedGoogle Scholar
  24. 24.
    Mowatt L, Shun-Shin GA, Arora S, Price N (2005) Macula off retinal detachments. How long can they wait before it is too late? Eur J Ophthalmol 15(1):109–117CrossRefGoogle Scholar
  25. 25.
    Batman C, Cekic O, Totan Y, Aslan O, Ozalp S (1999) Intraocular pressure changes in the vitreon study. Ophthalmic Surg Lasers 30(9):721–726PubMedGoogle Scholar

Copyright information

© Springer Nature B.V. 2019

Authors and Affiliations

  • Matthew Geiger
    • 1
  • Jesse M. Smith
    • 1
    Email author
  • Anne Lynch
    • 1
  • Jennifer L. Patnaik
    • 1
  • Scott C. N. Oliver
    • 1
  • James A. Dixon
    • 2
  • Naresh Mandava
    • 1
  • Alan G. Palestine
    • 1
  • The University of Colorado Retina Research Group
  1. 1.Department of OphthalmologyUniversity of Colorado School of MedicineAuroraUSA
  2. 2.Department of OphthalmologyKaiser Permanente ColoradoAuroraUSA

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