The Scottish Retinal Detachment Study: 10-year outcomes after retinal detachment repair

To address the paucity of long-term data on outcomes following rhegmatogenous retinal detachment (RRD) repair we aimed to establish the 10-year best corrected visual acuity (BCVA), redetachment rate and lens status for patients from the Scottish Retinal Detachment Study.

Data from patients who presented with RRD during the original study were collected from clinical records 10 years after repair. Patients were excluded if lacking 10 year follow-up data, and excluded from visual acuity analysis in the case of significant co-morbid ophthalmic disease.

103 patients had BCVA outcomes for at least 10 years post-operatively and met the inclusion criteria. 57 were macula-on and 46 were macula-off. Median10-year BCVA was 0.1 (IQR 0.3) logMAR (6/7.5). 10-year BCVA was significantly better in macula-on patients, compared to macula-off (-0.18 logMAR (p < 0.001)). There was a significant improvement in macula-off BCVA from short-term follow-up to 10-year BCVA (-0.26 logMAR, p = 0.04). 93% of macula-on patients achieved BCVA sufficient for UK driving standard compared to 65% of macula-off. There was no difference in 10-year BCVA between repair techniques. Thirty-four patients were phakic at follow-up, 65 pseudophakic, and 4 aphakic. Redetachment occurred in 14% and conferred a poorer 10-year BCVA (logMAR 0.3 IQR 0.78 (6/12)).

Long-term BCVA remains excellent following successful macula-on RRD repair with almost all macula-on, and most macula-off patients achieving the UK visual acuity driving standard. We demonstrate that macula-on detachments have significantly greater long long-term visual acuity than macula-off detachments, and that re-detachment is uncommon but confers a poorer long term visual outcome. This study provides objective long-term data to guide patient and surgeon expectations following retinal detachment repair.