Abstract

SO.08.10

Postoperative follow-up examination of rhegmatogenous retinal detachment by means of optical coherence tomography

Zorn M. M. C., Schmidbauer M., Lang G. K., Lang G. E.
Eyehospital of the University of Ulm

Objective: The study presents the course of the macular attachment either after buckling surgery or after pars plana vitrectomy for rhegmatogenous retinal detachment by OCT and ophthalmoscopy as well as the course of visual acuity pre- and postoperatively.
Methods: We examined 29 consecutive patients with rhegmatogenous retinal detachment according to a standardized protocol including pre- and postoperative BCVA, OCT examination of the macular area, stereoscopic ophthalmoscopy and a fundus photography. The attachment of the macular region was evaluated clinically and by means of OCT.
Results: Thirteen of 29 patients were treated by buckling surgery,16 by ppV. 22 patients needed one operation, 6 two operations and one patient needed three operations. 16 patients initially presented with a macular detachment, 6 of them were treated by buckling surgery and 10 by ppV. Preoperatively, BCVA ranged from hand motion to 1.0. (buckling procedure: median =0.6; ppV: median =0.067). At the last follow-up BCVA ranged from 0.05 to 1.25 (buckling procedure: median =0.6; ppV: median =0.25). When the macula was attached (pre- and postoperatively) BCVA changed from a median of 0.65 (preoperative) to 0.55 (last visit) (buckling surgery: from 0.6 to 0.7; ppV: from 0.65 to 0.4). If the macula was detached initially and was attached postoperatively BCVA improved from a median of 0.013 (preoperative) to 0.25 (last visit) (buckling surgery: from 0.025 to 0.4; ppV: from 0.013 to 0.175). The last follow-up examination showed that 4 patients suffered from a macular detachment, 3 in the buckling surgery group and one in the ppV group. Macula detachment was postoperatively more often verified by OCT examination than by clinical examination (4 vs 1).
Conclusions: Reattachment of the macular region occurs less often in the buckling surgery group than in the ppV group. OCT examination provides physicians with additional important informatioin regarding postoperative management of persistant macular detachment. Shallow macular detachment is visualized easier.

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