Comparison of Persistent Submacular Fluid in Vitrectomy and Scleral Buckle Surgery for Macula-Involving Retinal Detachment

Abstract

PURPOSE: To compare the frequency of persistent submacular fluid (SMF) and sequential visual outcomes after pars plana vitrectomy (PPV) and scleral buckling (SB) in recent-onset macula-involving rhegmatogenous retinal detachment (RD), and thus to determine the role of persistent SMF on visual outcome with different surgical methods. DESIGN: Observational case series. METHODS: Sixty-one patients (61 eyes) who underwent successful PPV (16 patients) or SB (45 patients) underwent thorough ophthalmologic examinations including optical coherence tomography at 1 month after surgery, as well as every 3 months until SMF disappeared. The SB group was divided into 2 groups according to the presence (SB-SMF+) or absence (SB-SMF-) of persistent SMF at 1 month after surgery. Preoperative and postoperative best-corrected visual acuities were compared among the different surgical groups and also were analyzed depending on the RD duration (acute, symptom duration <= 7 days; subacute, symptom duration > 7 and <= 30 days). RESULTS: Persistent SMF at 1 month after surgery was more frequent in the SB group (55.6%) than it was in the PPV group (6.25%; P = .006). The SB-SMF+ group showed worse postoperative best-corrected visual acuity than the PPV or SB-SMF- groups at 6 to 12 months after surgery, whereas there were no significant differences in the final visual acuity among the groups. This difference in visual recovery was not observed in patients with subacute RD. CONCLUSIONS: The similar visual recovery patterns seen in the PPV and SB-SMF- groups suggest that persistent SMF is a more important prognostic factor than surgical method is in the setting of acute onset and successful RD surgery. (Am J Ophthalmol 2010;149: 623-629. (C) 2010 by Elsevier Inc. All rights reserved.)