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

Int Ophthalmol. 2020 Mar;40(3):609-616. doi: 10.1007/s10792-019-01219-0. Epub 2019 Nov 25.


Purpose: 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.

Results: 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.

Conclusion: 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.

Keywords: Functional retina recovery; Pars plana vitrectomy; Primary macula-off; Rhegmatogenous retinal detachment; Scleral buckle.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Follow-Up Studies
  • Humans
  • Macula Lutea / diagnostic imaging
  • Macula Lutea / physiopathology*
  • Male
  • Middle Aged
  • Postoperative Period
  • Recovery of Function*
  • Retinal Detachment / diagnosis
  • Retinal Detachment / physiopathology
  • Retinal Detachment / surgery*
  • Retrospective Studies
  • Scleral Buckling / methods*
  • Visual Acuity / physiology*
  • Vitrectomy / methods*
  • Young Adult