Visual outcomes after surgery for primary rhegmatogenous retinal detachment in era of microincision vitrectomy
Reviewed by Jonathan Chan

This is a prospective, multicentre, nationwide study between 2016 and 2017, to investigate the preoperative ocular factors, surgical techniques (pars plana vitrectomy (PPV) or scleral buckling (SB), or combined procedures) for rhegmatogenous retinal detachment (RRD) and postoperative best corrected visual acuity (BCVA) at six months. The primary outcome was the percentage of eyes that achieved 20/25 vision in all groups. A total of 2192 patients were included (1738-PPV, 344-SB, 110-PPV+SB). Risk factors associated with less probability of postoperative BCVA 20/25 were: older age (>70 years, OR= 0.39), hypotony (<10mmHg, OR= 0.64), high myopia (>-3 dioptres, 0.62), multiple retinal breaks (>4, 0.6) giant retinal tear (>90 degrees, 0.12), extensive RD (>3 quadrants, 0.51) and macular-off (0.36). Those with preoperative BCVA </= 0 logMAR achieved good postoperative BCVA (OR=3,97). There was no significant difference between SB and PPV groups if cases had combined cataract surgery were excluded in the PPV group. Postoperative BCVA was 0.03 and 0.1 logMAR post SB and PPV respectively. The authors concluded that the limitations of this study are: estimation of duration of macular off detachments, missing data of axial length (421 cases), preoperative grading of the cataract and selection of surgery type was dependent on the surgeon’s experience.

Retina visual outcomes after surgery for primary rhegmatogenous retinal detachment in era of microincision vitrectomy: Japan-Retinal Detachment Registry Report IV.
Takayuki B, Kawasaki R, Yamakiri K, et al.
BRITISH JOURNAL OF OPHTHALMOLOGY
2021;105:227-32.