Surgical Outcomes of Rhegmatogenous Retinal Detachment in Young Adults

There exists a correlation between rhegmatogenous retinal detachment (RRD) in the setting of high myopia in younger adults, according to a study presented by Karen Rebecca Brown, MD, from the University of Texas Southwestern Medical Center in Dallas, TX, at the 37th ASRS Annual Meeting.

In a retrospective consecutive case series study, researchers evaluated 96 eyes from 38 patients of patient age 18-30 who had undergone primary surgical repair for RRD at a university referral center between 2014 and 2016. Patients were excluded if they had any documented trauma, retinal vascular disease, chorioretinal inflammatory disease, follow up less than three months, or prior surgical repair for RRD in their affected eye. The key outcomes comprised single surgery anatomic success (SSAS), overall anatomic success (OAS), and visual success, which was defined in this study as improvement in visual acuity (VA) by 15 or more letters on the Early Treatment Diabetic Retinopathy Study (ETDRS) letter score.

The findings showed that all eyes in the study were phakic and macula was attached in 10/38 (26%) while documented myopia was present in 28/38 (74%) eyes. Connective tissue disease was seen in 3/38 patients (8%). Moreover, the researchers observed that surgery was performed via scleral buckle (SB) alone in 27/38 (71%) and via combined SB and pars plana vitrectomy (SB/PPV) in 11/38 (29%) with no patients undergoing PPV alone. Overall, the study found that SSAS and OAS rates were 27/38 (71%) and 36/38 (95%), respectively. SSAS rate for SB was 20/27 (74%) and for SB/PPV was 7/11 (64%). OAS for SB was 25/27 (93%) and for SB/PPV was 11/11 (100%).

Moreover, visual success was achieved in 29/38 (76%) of eyes. For eyes that underwent SB, median postoperative Snellen VA was 20/40 and visual success was achieved in 20/27 (74%). For eyes that underwent combined SB/PPV, median postoperative Snellen VA was 20/100 and visual success was achieved in 9/11 (82%).

In their conclusion, the authors noted that the “predominance of SB as the primary treatment choice in this study is consistent with RRD treatment modalities reported in this age group. Use of SB may reflect the lack of posterior vitreous detachment and phakic lens status, and that “[v]isual and anatomic outcomes were favorable.”

Brown K. Surgical Outcomes of Rhegmatogenous Retinal Detachment in Young Adults. Presented at the 37th ASRS Annual Meeting; July 26-30, 2019; Chicago, IL.

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