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Duration of Retinal Detachment Associated With Postoperative Final Visual Outcome: Presented at COS By Louise Gagnon TORONTO -- June 24, 2009 -- The longer patients have had a detached retina, the less likely they will be able to restore their vision to what it was predetachment, a fact that ophthalmologists should communicate to their patients, researchers stated here at the 72nd Annual Meeting and Exhibition of the Canadian Ophthalmological Society (COS). “If patients present with retinal disasters, they want to know what their chances are of keeping their vision as it was before detachment,” explained Adam Muzychuk, University of Calgary, Calgary, Alberta, on June 22. “It’s important that we are able to tell patients what to expect after surgery,” he said. “There may be an excellent surgical result technically, but patients may not do as well [with their vision] for other reasons. It’s important to manage their expectations going into surgery.” Muzychuk and colleagues conducted a retrospective chart review of 229 patients (151 men, mean age 57.7 years) who had a mean spherical correction of -2.82. Investigators excluded patients who had a previous retinal detachment and repair or for whom no data were available. Using multiple logistic regression analysis, the researchers analysed whether factors such as patient demographics, disease status including duration of retinal detachment, location and extent of the detachment, surgical procedures, and postoperative intraocular pressure and fundus findings affected vision. Patients were divided into 3 groups based on duration of retinal detachment: <=2, 2 to 7, and >7 days. The researchers found that longer duration of retinal detachment was associated with poorer outcome in vision. The mean log minimal angle of resolution (MAR) visual acuity in patients who had duration of detachment <2 days was not available at week 1, 1.84 at 1 month, and 1.48 on final measurement. Among patients who had detachment for 2 to 7 days, the same measurement was 2.15 at 1 week, 1.98 at 1 month, and 1.91 for final outcome. For patients who had detachment for >7 days, the measurement was 2.17 at 1 week, 2.13 at 1 month, and 2.08 for final outcome. In addition, macular involvement; the presence of medical comorbidities, including diabetes, hypertension, and depression; secondary surgery; and refraction had a negative effect on the postoperative final visual outcome. “It was surprising to see that refractive status had an impact on visual acuity,” said Muzychuk. “People who were pathological myopes ended up doing better overall than people who were hyperopes, which is almost counterintuitive. “The pathological myopes may have been warned about the symptoms of detachment by ophthalmologists,” he continued. “They [patients] may be more vigilant and pick up the fact that there has been detachment. Consequently, they may have it repaired sooner.” The investigators found that, on average, the pathological myopes were treated 19 days sooner than the hyperopes who had retinal detachments. [Presentation title: Factors Affecting Visual Outcomes in the Surgical Repair of Retinal Detachment. Abstract 21] E-mail this page to a friend or colleague! To print, use this version