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Impressum
Long-term course after surgery of combined retinoschisis and retinal detachment
1,2Wiechens B., 2Siebert K.
1Dept. of Ophthalmology, Klinikum Hannover, Haltenhoffstr. 41, D-30167 Hannover, 2Dept. of Ophthalmology, Christian-Albrechts-University Kiel, Hegewischstr. 2, D-24105 Kiel
Objective: In combined retinoschisis and retinal detachment, a
rare form of retinal detachment, surgery to achieve reattachment of the
retina may be complicated by specific intra- and subretinal fluid accumulation.
Contradictory postoperative results have been reported in the literature.
The present study was performed to investigate the postoperative longterm
course of retinoschisis and retinal detachment compared to uncomplicated
rhegmatogenous retinal detachment.
Patients and methods: For this study 82 eyes of 82 consecutive
patients who had had detachment surgery in the Dept. of Ophthalmology
at CAU Kiel were re-examined. Group 1 (retinoschisis/ret. detachment):
n=36, Group 2 (rhegmatogenous ret. detachment): n=46. The mean
age of the patients at the time of diagnosis was 68.0 yrs in Group
1, and 58.5 yrs in Group 2. Mean follow-up was 7.2 yrs, and
5.1 yrs, respectively. Operation was performed as follows: scleral buckle
(23), primary PPV (9), cryopexy alone (4), in Group 2 scleral buckle
only.
Results: At the end of follow-up the retina was attached in all
cases of both groups. Postoperative visual acuity did not show any significant
differences between both groups (p=0,238). The primary success rate was
in 72,2 % Group 1, and 82,7 % in Group 2. However, compared
to Group 2 more reoperations were needed in Group 1 to achieve
the same anatomical and functional results (11 vs. 5). In this group no
differences were observed between buckling surgery and primary PPV.
Conclusions: In the long-term course no differences in postoperative
results could be observed in eyes with rhegmatogenous retinal detachment
alone or combined retinoschisis and retinal detachment. In the latter
primary success rate is reduced. More revisions are needed to achieve
the same anatomical and functional results as in uncomplicated rhegmatogenous
retinal detachment.