Abstract:Background: Rhegmatogenous retinal detachment (RRD) is a condition that can cause blindness and needs immediate surgical treatment to fix the anatomy and save the vision. The surgical results depend on several clinical factors including macular status, time to surgery, and the chosen surgical technique. In Iraq, there is a lack of data regarding visual outcomes after RRD repair in a real-world clinical setting.
Objective: The purpose of this study was to evaluate the surgical outcomes of retinal detachment procedures as well as the elements that determine post-operative visual recovery.
Methodology: A prospective observational study took place during 10 months from March 2024 to January 2025 with 250 patients who received primary RRD surgery at Tikrit Teaching Hospital and a private ophthalmology clinic. The treatment methods included pars plana vitrectomy (PPV) and scleral buckling (SB) and their combination. The evaluation of visual acuity and anatomical reattachment success occurred during a 6-month follow-up period. The researchers used SPSS version 23.0 for data analysis.
Results: The patients' average age was 52.3±13.7 years while the male population made up 55.2% of the total. The macula-off detachment condition occurred in 61.6% of all cases. The surgical procedure of PPV was used most frequently by surgeons (63.2%). The initial reattachment success rate reached 94.4% without any statistical differences between surgical approaches (p = 0.41). The mean best-corrected visual acuity (BCVA) showed a significant improvement from 1.36 logMAR before surgery to 0.52 at the six-month postoperative mark (p< 0.001). Patients who received surgery early after symptom onset and those with macula-on conditions achieved better results. The presence of preoperative proliferative vitreoretinopathy (PVR) led to higher re-detachment rates and worse visual recovery outcomes (p = 0.014).
Discussion: Modern surgical approaches have proven successful in achieving high anatomical success rates for RRD according to this study. The visual results depended heavily on three factors: macular condition and time until surgery and proliferative vitreoretinopathy (PVR) presence. The final BCVA results did not show any substantial differences between genders or surgical approaches. The study results demonstrate that prompt medical detection and prompt surgical intervention leads to better visual results.
