Retinal detachment with retinal dialysis among young males typically associated with trauma
A recent retrospective case series published in Ophthalmology Retina sheds light on the surgical approaches and outcomes for patients dealing with retinal detachment linked to retinal dialysis. This condition, often resulting from traumatic incidents, affects predominantly young male individuals. The study, spanning a decade from January 2012 to January 2022, uncovered valuable insights into the most effective treatment strategies.
The research, involving 60 eyes from 58 patients with an average age of 26.4 years, primarily consisted of males (84.5%). A notable 61.4% of cases were attributed to known trauma. The initial surgical methods employed included scleral buckling (SB) in 81.7% of eyes and a combined approach involving SB and pars plana vitrectomy (PPV) in 18.3% of cases.
The results unveiled a crucial correlation between preoperative best-corrected visual acuity (BCVA) and BCVA at the last follow-up visit, emphasizing the importance of early intervention. At the last follow-up, the SB group exhibited significant improvement with a mean BCVA of 0.36 (equivalent to 20/46) and a single-operation success rate of 76.9% at six months. In comparison, the SB/PPV group showed a mean BCVA of 1.08 (equivalent to 20/238) and a single-operation success rate of 77.8%. Notably, there were no significant differences in the success rates between these two approaches.
For those undergoing the combined SB/PPV procedure, six eyes received silicone oil tamponade. Over the course of one year or more follow-up, 100% of patients in this group developed visually significant cataracts necessitating cataract surgery, a notably higher rate compared to the SB group, where only 14.8% required cataract surgery.
These findings provide valuable insights for physicians dealing with retinal detachment associated with retinal dialysis. Scleral buckling as an initial treatment strategy has been reaffirmed as effective for most patients in this condition and appears to have a lower rate of cataract formation compared to the combined SB/PPV approach. The study underscores the importance of tailoring surgical strategies based on the patient's condition and age, with a focus on preserving visual acuity and minimizing the need for additional procedures.
Source:
Rohowetz, L. J., Jabbehdari, S., Smiddy, W. E., Berrocal, A. M., Townsend, J. H., Chang, J. S., Yannuzzi, N., Sridhar, J., Haddock, L. J., Fortun, J. A., & Flynn, H. W., Jr. (2023). Retinal Detachment Associated with Retinal Dialysis. In Ophthalmology Retina (Vol. 7, Issue 10, pp. 857–861). Elsevier BV. https://doi.org/10.1016/j.oret.2023.06.013
