• Retina/Vitreous

    Review of: Factors associated with good visual acuity outcomes after retinectomy in eyes with proliferative vitreoretinopathy

    Israilevich R, Starr M, Mahmoudzadeh R, et al. American Journal of Ophthalmology, August 2022

    Identifying factors that predict better outcomes following retinal detachment (RD) repair for proliferative vitreoretinopathy (PVR) undergoing retinectomy has mostly been examined using anatomic assessment. This study attempted to correlate predictive factors and visual outcomes.

    Study design

    This is a single site, retrospective, age- and gender-matched cohort study of 181 eyes undergoing rhegmatogenous retinal detachment (RD) surgery with retinectomy. The outcomes showed results of the procedure among patients in a good visual acuity (VA) group with vision better than 20/70 compared to a cohort of poor VA greater than or equal to 20/70. The study used multivariate analysis to look at type of surgery, tamponade, extent of retinectomy, extent of PVR, macular status, and preoperative VA.

    Outcomes       

    Univariate analysis did not show a difference between the good and poor VA groups. However, showing statistical significance between the 2 groups were factors including size of the initial RD, number of overall surgeries, time between diagnosis of recurrent RD and subsequent surgery, preoperative VA, and pseudophakia at final visit. Of note, preoperative macula status was not found to be significant, despite its presumed clinical significance.

    Limitations

    The study’s limitations include retrospective design, refractions were not performed, and OCT data was not included. Visual quality was not assessed, and the controls were not matched by macula status. This study included patients from multiple surgeons, so there was variable technique.

    Clinical significance

    The main takeaway from the study is that even with a retinectomy, patients can still recover good vision. The other factors found to influence visual outcome were smaller initial RD size, fewer surgeries, shorter time between recurrent RD diagnosis and subsequent surgeries, better preoperative VA, and pseudophakia at final visit.