Impact of Foveal Status and Timing of Surgery on Visual Outcome in Rhegmatogenous Retinal Detachment
Zeeshan Haq, Robert A. Mittra, D. Wilkin Parke, Yoshihiro Yonekawa, Jason Hsu, Omesh Gupta, George A. Williams, Gaurav K. Shah, Edwin H. Ryan- Ophthalmology
- General Medicine
Abstract
Purpose:
To investigate the impact of surgical timing on visual acuity (VA) outcomes in retinal detachments (RD) based on preoperative foveal status.
Methods:
A retrospective multicenter cohort study was conducted. Cases were stratified into fovea-on, fovea-split, and fovea-off groups. Days to surgery was defined as the time between the preoperative examination and surgery. The main outcome measure was final postoperative VA.
Results:
1675 cases were studied. More than 80% of fovea-on/fovea-split and fovea-off cases had surgery within 1 and 3 days, respectively. The mean final postoperative VA did not differ significantly between the fovea-on and fovea-split groups (SE 20/33 ± 20/49 and 20/32 ± 20/39, p = 1.000) and did not change significantly based on days to surgery in either group. The mean final postoperative VA was lowest in the fovea-off group (Snellen equivalent [SE] = 20/56 ± 20/76, p < 0.001) and was significantly lower in cases where surgery was performed after 2 or more days when compared to cases performed within 1 day (SE 20/74 ± 20/89 vs 20/46 ± 20/63, p < 0.001).
Conclusions:
Fovea-on and fovea-split RDs demonstrated comparable visual outcomes. Fovea-off RDs demonstrated worse visual outcomes, which declined further when surgery was delayed by 2 or more days.