Photoreceptor Disruption Related to Persistent Submacular Fluid after Successful Scleral Buckle Surgery.
10.3341/kjo.2011.25.6.380
- Author:
Se Joon WOO
1
;
Kyoung Min LEE
;
Hum CHUNG
;
Kyu Hyung PARK
Author Information
1. Department of Ophthalmology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea. jiani4@snu.ac.kr
- Publication Type:Original Article ; Research Support, Non-U.S. Gov't
- Keywords:
Optical coherence tomography;
Photoreceptor cells;
Retinal detachment;
Sclera buckling;
Subretinal fluid
- MeSH:
Adolescent;
Adult;
Aged;
Aged, 80 and over;
Aqueous Humor/*metabolism;
Child;
Female;
Follow-Up Studies;
Humans;
Male;
Middle Aged;
Photoreceptor Cells/*pathology;
*Postoperative Complications;
Prospective Studies;
Retinal Detachment/*surgery;
*Scleral Buckling;
Tomography, Optical Coherence;
Visual Acuity/physiology;
Young Adult
- From:Korean Journal of Ophthalmology
2011;25(6):380-386
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: To investigate serial changes in photoreceptor status and associated visual outcome in patients with persistent submacular fluid after successful scleral buckle surgery for macula-off rhegmatogenous retinal detachment. METHODS: This was a prospective observational case series including 76 consecutive patients who underwent successful scleral buckle surgery for macula-off rhegmatogenous retinal detachment with symptom duration < or =90 days at a single tertiary hospital. Optical coherence tomography (OCT) and visual acuity examination were performed at one month and three months postoperatively and at three-month intervals until the submacular fluid disappeared. Main outcome measures were postoperative photoreceptor status on OCT and visual acuity. RESULTS: Forty-two patients (55.3%) showed persistent submacular fluid at postoperative one month. Of 42 patients with persistent submacular fluid, three (7.1%) showed photoreceptor disruption on OCT. None of the 34 patients without persistent submacular fluid showed photoreceptor disruption. Two patients (4.8%) had progressive photoreceptor disruption, and one patient (2.4%) had early photoreceptor disruption. All three patients showed photoreceptor reappearance and limited visual restoration after absorption of submacular fluid. Final visual acuities were significantly worse in these three patients (20 / 1000, 20 / 133, and 20 / 133) compared to those of the other patients (mean, 20 / 30) with persistent submacular fluid and intact photoreceptors. CONCLUSIONS: Even after successful scleral buckle surgery for rhegmatogenous retinal detachment, photoreceptor disruption can occur related to persistent submacular fluid and may be a cause of poor visual outcome.