|Year : 1982 | Volume
| Issue : 6 | Page : 573-578
Visual recovery after successful surgery in cases of retinal detachment with macular involvement.
Saroj J Shah, Ushah Vyas, BKK Hamar
M & J Institute of ophthalmology Ahmedabad, India
Saroj J Shah
M & J Institute of ophthalmology Ahmedabad
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Shah SJ, Vyas U, Hamar B. Visual recovery after successful surgery in cases of retinal detachment with macular involvement. Indian J Ophthalmol 1982;30:573-8
We are presenting this paper to find out relationship between recovery of visual acuity and pre-operative operative parameters. The analysis of 100 consecutive cases of detachment treated successfully where macular was involved is presented.
| Materials and methods|| |
Selection of patients-l00 Cases of Rhagmatogenous detachment showing macular involvement were included in the study. Those patients having opacites in cornea of lens and macular pathology, or preexisting amblyopia were excluded. Best corrected vision was noted pre and post-operatively. Duration of macular involvement was noted from the day the patient had symptoms to the day of operation. Extent of detachment was noted meridian wise involving peripheral retina.
| Observations|| |
An average visual recovery in our series is 6/36. The Maximum benefitted age group is between 61-70 years. Age group 21-30 years is bad regarding visual gain. 71.5% of patients in age group 61-70 years has gained vision 6!36 or beter. [Figure - 1] a
The visual recovery is inversely proportional to duration of detachment. 100% of patients coming in the first week get 6/36 or better vision while 66 6% of patients coming after 3 months recover less than c.f. 3 meters. after operation. [Figure - 1] b
[Table - 1]. shows ration between pre-operavision and post operative visual recovery. 63% of patients having pre-operative vision more than PR4, achieved 6/36 or more vision after operation, while only 55% vision achieved this when their pre-operative was PR4. vision This shows high myopics had poor prognosis. Myopics having less than 5.00 D. refraction and apahkics fare well. Visual recovery again was inversely proportional to extent of detachment. If detachment is less than 360°, [Figure - 2] approximately 55-60% chances are that to gain good vission. The recovery does not depend upon the extent of coagulative procedure which is proportionate to the extent of lesion. [Table - 2][Table - 3]
| Discussion|| |
Average visual acuity : - It is 6/36 in this series.
Relationship between age and visual recovery :-- In this series best results were found between age group 61-70 years who obtained best results.
Poor prognosis is found in extreme ages. Z1-30 years age group regained very poor vision probably beeause majority of patients were high myopic and remaining were of total detachments of more than 3 months which are otherwise also bad prognosis cases.
Duration and post-operative visual acuity :
In this, all patients having duration less than 7 days attained good vision. Between 15 days to 3 months only 55% attained 6/36 or more and 30% attained C.F. 3 meters or less in this series.
Pre-operative and post-operative visual acuity :- Pre-operative vision in this series ranged from PLPR 4+ to C.F. 2 meters.
Visual recovery was better in the patients having more than PR4 vision at the time of operation. While recovery rate reduced where pre-operative vision was PR4 only.
Refractive status and post-operative visual acuity :- Chances of regaining 6/36 or better vision were less with myopic patients, which is difficult to explain.
Extent of retinal detachment and postoperative visual acuity :- Chances of obtaining good visual acuity are around 58% if extent is less than 270° but reduces to 31 % when it becomes 360°. Incidents of geeting poor vision increase gradually with increase in extent.
Extent of diathermy and cryo application to post-operative visual acuity :- In absence of any complications, post-operative visual acuity is not related to cryo or diathermy which is proportional to pathological lesions found.
| Summary|| |
Hundred cases of successful treated retinal detachments with involvement of macula are analysed to find out possible parameters which can guide to post-operative visual recovery.
[Figure - 1], [Figure - 2]
[Table - 1], [Table - 2], [Table - 3]