Visual prognosis and factors affecting in successful retinal detachment surgery

Purpose: To investigate pre operative and post operative factors affecting functional success in anatomically successful retinal detachment surgery Materials and Methods: 75 eyes of 75 patients with rhegmatogenous retinal detachment (RRD) who underwent anatomically successful surgery, from January 2014 to May 2019 were included in the study. Demographic characteristics, ocular examination findings, post operative OCT images were retrospectively evaluated. OCT images were evaluated by two different clinician who did not know patient's examinations. Results: Of the patients, 34 (45%) were female and 41 (55%) were male. The mean age was 53.9 ± 17 (range: 11 to 85 years). The mean follow-up period was 36.7 ± 16 (range: 12-72) months. The best corrected visual acuity (BCVA) of the patients before surgery was logMAR 1.35 ± 1.24 (logMAR 0-3.7). At the final follow-up after surgery, BCVA was logMAR 0.58 ± 0.5 (LogMAR 0-1.6). 33 patients who were operated within the first 7 days after the onset of complaints were compared with the other patients, the patients who were operated in the first 7 days were found to have statistically significant BCVA in the first month, 3rd month, 6th month, 12th month and final examination. Preoperative vitreous hemorrhage (VH) or proliferative vitreo retinopathy (PVR) have a negative effect on functional success in patients. Diffusiveness of retinal detachment in patients affects OCT findings and functional success. Preoperative external limiting membrane (ELM) integrity affects the functional success and regeneration of retinal layers in patients. Regeneration of the outer layers of the retina has a positive effect on functional success. Conclusion: In this study, it was found that early surgery in patients, presence of preoperative ELM integrity and restoration of post operative retinal outer layers positively affected functional success. The presence of preoperative VH, PVR and the diffusiveness of detachment had a negative effect on prognosis. Using this study, we can comment on the functional prognosis of rhegmatogenous retinal detachment patients.