Impact of Foveal Status and Timing of Surgery on Visual Outcome in Rhegmatogenous Retinal Detachment.

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Retina (Philadelphia, Pa.)


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.





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