The Scottish Retinal Detachment Study: 10-year outcomes after retinal detachment repair.

Abstract

Objective: To address the paucity of long-term data on outcomes following rhegmatogenous retinal detachment (RRD) repair we aimed to establish the 10-year best corrected visual acuity (BCVA), redetachment rate and lens status for patients from the Scottish Retinal Detachment Study.

Subjects: Data from patients who presented with RRD during the original study were collected from clinical records 10 years after repair. Patients were excluded if lacking 10 year follow-up data, and excluded from visual acuity analysis in the case of significant co-morbid ophthalmic disease.

Results: 103 patients had BCVA outcomes for at least 10 years post-operatively and met the inclusion criteria. 57 were macula-on and 46 were macula-off. Median10-year BCVA was 0.1 (IQR 0.3) logMAR (6/7.5). 10-year BCVA was significantly better in macula-on patients, compared to macula-off (-0.18 logMAR (p < 0.001)). There was a significant improvement in macula-off BCVA from short-term follow-up to 10-year BCVA (-0.26 logMAR, p = 0.04). 93% of macula-on patients achieved BCVA sufficient for UK driving standard compared to 65% of macula-off. There was no difference in 10-year BCVA between repair techniques. Thirty-four patients were phakic at follow-up, 65 pseudophakic, and 4 aphakic. Redetachment occurred in 14% and conferred a poorer 10-year BCVA (logMAR 0.3 IQR 0.78 (6/12)).

Conclusion: Long-term BCVA remains excellent following successful macula-on RRD repair with almost all macula-on, and most macula-off patients achieving the UK visual acuity driving standard. We demonstrate that macula-on detachments have significantly greater long long-term visual acuity than macula-off detachments, and that re-detachment is uncommon but confers a poorer long term visual outcome. This study provides objective long-term data to guide patient and surgeon expectations following retinal detachment repair.