2M.D. Professor, Baskent University Faculty of Medicine, Department of Ophthalmology, Ankara/TURKEY Purpose: To evaluate IS/OS and ELM junction and restauration with spectral-domain optical coherence tomography (SD-OCT), anatomical and functional outcome after scleral buckling surgery (SBS) in macula-off rhegmatogenous retinal detachment (RRD).
Materials and Methods: Medical charts of 81 eyes, who underwent SBS for macula-off RRD were retrospectively analysed. Reattachment success rates, pre- and postoperative visual acuity (VA) were examined. Postoperative SD-OCT images were obtained at 6. month to evaluate the status of photoreceptor IS/OS and ELM junction. OCT characteristics were correlated with final VA. Risk factors influencing postoperative VA were evaluated by using linear multivariate logistic regression. P values <0.05 were considered statistically significant. Postoperative at 12. month VA was examined, IS/OS and ELM restauration was evaluated with SD-OCT in 76 eyes.
Results: The primary anatomic success rate was 93.8% (76 eyes), final success rate was 98.8% (80 eyes). Preserved ELM (p=0.003) and IS/OS integrity (p=0.029), drainage of subretinal fluid (p<0.0001) were significant independent factors for influencing postoperative VA favourable. Duration of detachment >6 days (p=0.04), two/three retinal breaks (p<0.0001) and severe IS/OS disruption (p<0.0001) were significant independent risk factors for a poor postoperative VA. Severe IS/OS disruption was the most important risk factor for poor postoperative VA. Posoperatively at 12 months in 64% and 52% of eyes IS/OS and ELM restauration with increase in VA was detected
Conclusion: IS/OS and ELM-integrity may be important independent predictors of postoperative VA. Severe IS/OS disruption may be the most important risk factor for poor postoperative VA. IS/OS and ELM restauration may permit increase in VA.
Keywords : Rhegmatogenous retinal detachment, scleral buckling surgery, optical coherence tomography, IS/OS-ELM restauration