Abstract

SA.10.01

Functional and anatomical outcome after retinal detachment surgery depending on the pre- and intraoperative findings as prognostical factors

Nicolas Feltgen1, Peter Walter2, Hans Hoerauf1, Heinrich Heimann3, Ralf-Dieter Hilgers4, Nicole Heussen4, Die SPR Studiengruppe
1Universitäts-Augenklinik Göttingen, 2Universitäts-Augenklinik der RWTH Aachen, 3St. Paul`s Eye Unit, Royal Liverpool University, Liverpool, United Kingdom, 4Institut für Medizinische Statistik, Universität Aachen, Aachen

Objective
The fetal development of the human eye has been thoroughly studied but the evaluation of prenatal findings in disease processes is sparse. In some syndromes ocular involvement of the adult eye is well known. However, the presence and extent of prenatal changes remain unclear, possibly also due to the difficulty in distinguishing iatrogenic trauma or autolysis. Here, we have chosen the most interesting cases from our collection of fetal eyes for presentation and discussion.
Methods
Pre- and intraoperative dataset of 680 patients could be analysed. We evaluated the intraoperative findings based on the fundus drawings and surgical report of the all patients. The evaluation was performed by three ophthalmologists on the basis of a majority vote.
Results
1. Functional result: In phakic subtrial reduced preoperative BCVA (p=0.0002) and multiple retinal breaks (p=0.0224) correlated with reduced final BCVA. Further significant factors were total retinal detachment (RD) (p=0.0021), central RD (p=0.0133) or chain formation of breaks (p=0.0021). In pseudo- or aphakic patients multiple retinal breaks (p=0.0015), secondary cataract formation (p=0.0127), intraoperative use of laser (p=0.0299) subretinal drainage (p=0.0099) and lattice formation (p=0.0109) correlated with reduced final BCVA. The surgical method did not influence the final BCVA however surgeon did influence the functional result in the pseudophakic or aphakic group.           
2. Anatomical result: Neither surgical method nor the factror surgeon correlated with the final anatomical result. In phakic patients multiple retinal breaks (p=0.0014) subretinal drainage (p=0.009) and with breaks in chain formation (p=0.0054) correlated with a reduced final anatomical outcome. In pseudophakic or aphakic patients multiple breaks (p=0.044) or the use of laser was correlated with worse anatomical outcome.
Conclusions
Final anatomical and functional results correlated with pre- and intraoperative findings and not the surgical method. The most important factor was the number of retinal breaks.

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