Anatomic and visual outcomes in early versus late macula-on primary retinal detachment repair

The purpose of this study was to describe the single surgery anatomic success rates and visual outcomes of primary macula-on retinal detachment repaired within 24 hours compared with later than 24 hours.

This is a retrospective, comparative, interventional, consecutive case series. All eyes underwent primary surgical repair of the macula-on retinal detachment with a scleral buckle, pars plana vitrectomy, or combination of both procedures. The duration from the initial examination to the time of surgical repair was categorized as early (<24 hours) versus late (>24 hours).

Sixty-six eyes, 42 phakic and 24 preoperative pseudophakic, had retinal detachment repair with a median time to surgery of 1.0 ± 2.1 days (0.8 ± 0.4 days in early group versus 3.7 ± 2.2 days in late group, P < 0.005). The overall single surgery anatomic success rate was 59 of 66 eyes (89%). The single surgery anatomic success rate between the early (32 of 37 [87%]) versus late (27 of 39 [93%]) repair groups showed no statistical difference (P = 0.45). The mean time of follow-up was 13.1 months (range 0.9-39.2 months) with the mean final logarithm of the minimum angle of resolution best-corrected visual acuity showing no statistical difference between the 2 groups (early [0.10 ± 0.02] versus late [0.12 ± 0.03], t-test; P = 0.52). The rates of postoperative glaucoma (P = 0.5) and hemorrhage (P = 0.19) did not differ significantly between the 2 groups.

Delaying the repair of primary macula-on retinal detachment by more than 24 hours does not appear to cause worse visual or anatomic outcomes compared with early (<24 hours) surgical intervention. There was no significant difference in the complication rates between the two groups.