Outcomes of Surgery for Complex Rhegmatogenous Retinal Detachment in Eye Foundation Hospital, Lagos, Nigeria

Abstract

Aim: To report the visual and anatomic outcomes of surgery for complex rhegmatogenous retinal detachment in a tertiary eye hospital in Africa over a 5 year period. Methods: Data was obtained from case files of patients who had surgery for complex rhegmatogenous retinal detachment between January 2014 and December 2018 in Eye Foundation Hospital Lagos, Nigeria. Visual and anatomic outcomes were analyzed and logistic regression done to identify factors associated with primary anatomic success, final anatomic success and good visual outcome. Results: A total of 343 eyes of 340 patients that met the inclusion criteria were analyzed. There were 249 (73.2%) males and 91 (26.8%) females with age ranging from 7 to 87 years with a mean age of 49.43 years. Only 41 (12.9%) eyes presented within a week of onset of symptoms, 263 (76.9%) eyes had vitrectomy with silicon oil exchange, 13 (3.8%) eyes had vitrectomy with gas, 15(4.4%) eyes had scleral buckling surgery alone while 51 (14.9%) eyes had combined scleral buckle with vitrectomy. Primary anatomical success was achieved in 281 (88.7%) eyes, Final anatomical success was achieved in 288 (92.9%) eyes and good visual outcomes achieved in 208 (61.4%) eyes. Using a simple logistic regression, eyes with normal or near normal visual acuity at presentation were more likely to have good visual outcomes (p = 0.00034). When compared with macula off rhegmatogenous retinal detachment, eyes with macula on at presentation also had a higher likelihood of final anatomic success (p = 0.001). Conclusion: Despite complex pathology in eyes with rhegmatogenous retinal detachment, good anatomic and visual outcomes can be achieved after surgery. Primary anatomic success was achieved in 88.7% of eyes and 92.9% of eyes achieved final anatomic success. Good visual outcomes were achieved in 61.4% of eyes. Eyes with normal or near normal visual acuity at presentation were more likely to have good visual outcomes (p = 0.00034). When compared with macula off RRD, eyes with macula on at presentation had a higher likelihood of final anatomic success (p = 0.001).