Optical coherence tomography evaluation of patients with macula-off retinal detachment after different postoperative...

Area of Science:

• Ophthalmology
• Retinal Surgery
• Medical Imaging

Background:

• Macula-off rhegmatogenous retinal detachment (RRD) requires surgical intervention.
• Postoperative management, including patient positioning and the use of perfluorocarbon liquid (PFCO), may influence surgical outcomes.
• Spectral domain optical coherence tomography (SD-OCT) is crucial for evaluating retinal structural integrity post-surgery.

Purpose of the Study:

• To evaluate the effect of different postoperative postures (prone vs. supine) and the use of adjuvant perfluorocarbon liquid (PFCO) on the development of outer and inner retinal folds (RFs) and ellipsoid zone (EZ) dropout after RRD repair.
• To assess the impact of these interventions on postoperative best-corrected visual acuity (BCVA).

Main Methods:

• A prospective study involving 56 patients with RRD undergoing pars plana vitrectomy (PPV).
• Patients were randomized into four groups based on postoperative posture (prone or supine for 5 hours) and PFCO use (with or without).
• SD-OCT imaging was performed preoperatively and at 30 and 90 days postoperatively to assess retinal folds and EZ status.

Main Results:

• No statistically significant differences were observed in the formation or evolution of outer RFs, inner RFs, or EZ dropout among the four groups.
• All patient groups demonstrated significant improvement in BCVA post-surgery (p < 0.01).
• There were no statistically significant variations in postoperative BCVA between the treatment groups.

Conclusions:

• The choice of postoperative posture and the preoperative use of PFCO do not alter the risk of developing outer RFs, inner RFs, or EZ dropout after RRD surgery.
• Surgical repair of RRD leads to visual acuity improvement regardless of the specific postoperative management strategies investigated.