Retinal displacement following rhegmatogenous retinal detachment: A systematic review and meta-analysis

Surv Ophthalmol. 2022 Jul-Aug;67(4):950-964. doi: 10.1016/j.survophthal.2022.01.002. Epub 2022 Jan 8.

Abstract

Retinal displacement following rhegmatogenous retinal detachment (RRD) repair is an important consideration when assessing the integrity of reattachment, with potential implications on functional outcomes. There are limited data comparing various surgical techniques. We conducted a review of retinal displacement following RRD repair through October 2021, finding 21 studies encompassing 1,258 unique eyes. Outcome measures included the frequency of retinal displacement, visual acuity, metamorphopsia, and displacement direction. A meta-analysis was performed with data reported as risk ratios (RR) or mean difference and 95% confidence intervals. Retinal displacement was found in 35 ± 20% of RRD repairs. Scleral buckle (SB) without tamponade had the lowest rate of retinal displacement, followed by pneumatic retinopexy (PnR) and finally pars plana vitrectomy (PPV) (RR in PPV vs SB: 9.60 [2.01-45.95], P = 0.005). Silicone oil may reduce risk of displacement following PPV compared to gas (RR in gas vs SO: 2.16 [1.22-3.83], P = 0.009), as may immediate face-down positioning for 2 hours. Retinal displacement following PPV occurred in the downward direction in 92 ± 14% of cases and does not appear to significantly impact visual acuity (0.05 [-0.21 to 0.31], P = 0.70), although it may increase distortion. SB, PnR, PPV with silicone oil, and immediate face-down positioning are likely associated with less retinal displacement. Additional prospective studies are required to increase the certainty of these findings.

Keywords: high-integrity retinal attachment; low-integrity retinal attachment; retinal displacement; retinal vessel printings; rhegmatogenous retinal detachment.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Humans
  • Retinal Detachment* / etiology
  • Retinal Detachment* / surgery
  • Retrospective Studies
  • Scleral Buckling / methods
  • Silicone Oils
  • Treatment Outcome
  • Vitrectomy / methods

Substances

  • Silicone Oils