97th DOG Annual Meeting 1999



T. Woldt, B. Wiechens

Background: Retinal detachment including the macula is always associated with rapid loss of vision. It is generally assumed that even after successful reattachment of the macula visual prognosis is unfavorable, depending on the duration of detachment prior to surgery. In this retrospective study we therefore investigated, how the postoperative course of the recovery of macular function is.

Patients and Methods: All patients with the diagnosis "retinal detachment" were extracted from the files of the Dept. of Ophthalmology of Christian-Albrechts-University Kiel who were admitted for buckling surgery during the period January 1990 and December 1991. All eyes with myopia (> -1 D), macular diseases and previous vitreoretinal surgery were excluded. Finally 2 groups of patients were re-examined: a study group (SG) with detached macula (48 eyes) and a control group (CG) without macular involvement (40 eyes ). Follow-up was up to 96 months. All intervening visual acuity data were obtained from the patients┬┤ private ophthalmologists.

Results: At the end of follow-up all eyes showed attached retinas. 29 patients of the SG and 37 patients of the CG had binocular vision. Prior to retinal detachment the median visual acuity (V.A.) in both groups was 20/25. On admission the V.A. was hand movements in the SG and 20/40 in the CG. Three to 6 months postoperatively the eyes in the CG reached baseline-V.A. again. The V.A. in the SG gradually increased over time. Median V.A. after 3 months was 20/50. Surprisingly, even 18 to 24 months after surgery recovery of macular function of up to a median V.A. of 20/30 was observed.

Conclusions: After successful reattachment of the macula gradual recovery of macular function can be observed of up to 18 months. Moreover baseline visual acuity can be reached again after this period.

Section of Vitreoretinal Surgery, Dept. of Ophthalmology,
Christian-Albrechts-University, Hegewischstr. 2, D-24105 Kiel