Michalewska Zofia*, Cisiecki Slawomir, Michalewski Janusz, Odrobina Dominik, Bednarski Maciej, Nawrocki Jerzy (Lodz, Poland)

Premise:

Spectral Domain Optical Coherence Tomography (SD-OCT) may demonstrate in the retinal architecture after primary pars plana vitrectomy an explanation as to why visual acuity may not recover fully after surgery.

Methods:

This is a single center, prospective analysis of 121 consecutive eyes following primary vitrectomy, evaluated with SD-OCT 1, 3 and 12 months after surgery. Patients with rhegmatogenous retinal detachment with no prior surgery except phacoemulsification were included. The following data were examined: initial and follow-up visual acuity, type of retinal detachment, number of procedures performed, epiretinal membrane, macular edema, photoreceptor and external limiting membrane defects, subretinal fluid, retinal pigment epithelium defects, central retinal thickness.

Effectiveness / Safety:

Mean initial visual acuity was 0.05 (SD: 0,14) and mean final visual acuity was 0,15 (SD: 0,12). The mean number of additional procedures including silicone oil removal was 1.2. Photoreceptor and external limiting membrane defects were present in 76 eyes (63%). Epiretinal membranes were present in 66 eyes (55%) of cases. Thinning of the fovea was observed in 4 eyes (3%). Macular edema was observed in 22 eyes (18%). Mean central retinal thickness was 273um (SD:171um). Subretinal fluid was present in 22 eyes (18%).

Take home message:

The most important factor correlating with postoperative visual acuity in eyes after primary vitrectomy for retinal detachment was the size of photoreceptor defect.