Functional results of surgical treatment of retinal detachment

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The article analyzes the state of patients’ visual acuity after successful surgical treatment of retinal detachment. On the basis of gathered data, it was concluded that in case of detachment of the macula only in 50% of cases it is possible to increase visual acuity to 0.4 and higher. Restoration of visual functions continues for at least 6 months after the operation and is determined by the restoration of the structure of the outer segments of the photoreceptor cells. During this time, it is advisable to conduct drug therapy aimed at normalizing blood flow and functional activity of the retina. Visual functions recovery continues for at least 6 months after the operation and is connected with the restored structure of the outer segments of the photoreceptor cells. Important prognostic factors of central vision restoration in the postoperative period are visual acuity before surgery, duration of existence and height of macular detachment. Data on which of the methods of surgical treatment of retinal detachment allows to achieve higher visual acuity are contradictory. There is practically no data on the comparison of the effect on visual acuity of scleral buckling and vitrectomy in the long-term period, in patients with phakic eyes and with artiphakia. On visual acuity after fitting detachment of the macula may affect macular edema, epiretinal membrane formation and retinal folds, and edema of the peripapillary optic nerve head, progressive deterioration of blood flow in the basin of the central retinal artery, short posterior ciliary arteries and ophthalmic artery. It is believed that these factors are significantly more pronounced after scleral buckling than after vitrectomy. Some indicators of optical coherence tomography correlate with visual acuity after surgical treatment of retinal detachment: the state of the articulation line of the external and internal segments of the photoreceptors, as well as the state of the external limiting membrane.

About the authors

O. E. Ilyukhin

Peoples’ Friendship University of Russia (RUDN University)

Author for correspondence.
Moscow, Russian Federation

M. A. Frolov

Peoples’ Friendship University of Russia (RUDN University)

Moscow, Russian Federation

K. V. Ignatenko

Peoples’ Friendship University of Russia (RUDN University)

Moscow, Russian Federation


  1. Wilkinson C.P., Rice T.A. Michel’s retinal detachment. 2nd ed. St. Louis, MO: Mosby. 1997. P. 935-977.
  2. Aznabaev M.T. Causes of low visual function and rehabilitation methods in patients after successfully operated retinal detachment. Vestn. Ophthalmol. 2005; 5:50-2.
  3. Азнабаев М.Т. Причины низких зрительных функций и методы реабилитации у больных после успешно оперированной отслойки сетчатки // Вестник Офтальмолия. 2005. № 5. C. 50-52.
  4. Nesterov S.A. Functional studies of the organ of vision during retinal detachment, their significance for the prognosis and assessment of the results of scleroplastic operations. PhD Thesis. MD. М., 1969. 29 p.
  5. Нестеров С.А. Функциональные исследования органа зрения при отслойке сетчатки, их значение для прогноза и оценки результатов склеропластических операций // Автореф. дисс. канд. мед. наук. М.,1969. 29 с.
  6. Neroev V.V., Kiseleva T.N., Sarygina O.I. et al. Hemodynamics of the eye during surgical treatment of idiopathic macular ruptures using various types of vitreous endotamponade. Russian Ophthalmological Journal. 2014;7(2):57-61.
  7. Нероев В.В., Киселева Т.Н., Сарыгина О.И. и др. Гемодинамика глаза при хирургическом лечении идиопатических макулярных разрывов с применением различных видов эндотампонады витреальной полости // Российский офтальмологический журнал. 2014. Т.7. № 2. С. 57-61.
  8. Zaika V.A., Yakimov A.P., Yuryeva T.N. Causes and mechanisms of non-restoration of visual functions in the late postoperative period in patients operated on for regmatogenous retinal detachment. Modern technologies in ophthalmology. 2016;1:79-91.
  9. Зайка В.А., Якимов А.П., Юрьева Т.Н. Причины и механизмы невосстановления зрительных функций в позднем послеоперационном периоде у пациентов, прооперированных по поводу регматогенной отслойки сетчатки // Современные технологии в офтальмологии. 2016. № 1. С. 79-91.
  10. Tornambe P.E., Hilton G.F. Pneumatic retinopexy. A multicenter randomized controlled clinical trial comparing pneumatic retinopexy with scleral buckling. The Retinal Detachment Study Group. Ophthalmology. 1989;96:772-83.
  11. Zaika V.A. Pathogenetic and sanogenetic mechanisms determining the outcome of surgical treatment of retinal detachment. PhD Thesis. Irkutsk, 2015. 155 с.
  12. Зайка В.А. Пато- и саногенетические механизмы, определяющие исход хирургического лечения отслойки сетчатки // Дисс. канд. мед. наук. Иркутск, 2015. 155 с.
  13. Soni C., Hainsworth D.P., Almony A. Surgical management of rhegmatogenous retinal detachment: a meta-analysis of randomized controlled trials. Ophthalmology. 2013;120:1440-7.
  14. Machemer R. Experimental RD in the owl monkey. 3. Electron microscopy of retina and pigment epithelium. Am.J. Ophthalmol. 1968;66:410-27.
  15. Anderson D.H., Stern W.H., Fisher S.K., et al. RD in the cat: the pigment epithelial-photoreceptor interface. Invest. Ophthalmol. Vis. Sci. 1983;24:906-26.
  16. Berglin L., Algvere P.V., Seregard S. Photoreceptor decay over time and apoptosis in experimental retinal detachment. Graefes Arch Clin Exp Ophthalmol. 1997;235:306-12.
  17. Chang C.J., Lai W.W., Edward al. Apoptotic photoreceptor cell death after traumatic RD in humans. Arch. Ophthalmol. 1995;113:880-6.
  18. Burton T.C. Preoperative factors influencing anatomic success rates following retinal detachment surgery. Trans. Sect. Ophthalmol. Am. Acad. Ophthalmol. Otolaryngol. 1977;83:499-505.
  19. Kosarev S.N., Denisova I.P., Oleinichenko O.A. Extrascleral surgery of retinal detachment: failure analysis. Modern technologies for the treatment of vitreoretinal pathology. М., 2009. С. 110-111.
  20. Косарев С.Н., Денисова И.П., Олейниченко О.А. Экстрасклеральная хирургия отслойки сетчатки: анализ неудач // Современные технологии лечения витреоретинальной патологии. М., 2009. С. 110-111.
  21. Reese A.B. Defective central vision following successful operations for detachment of the retina. Am.J. Ophthalmol. 1937;20:591-8.
  22. Wolfensberger T.J., Gonvers M. Optical coherence tomography in the evaluation of incomplete visual acuity recovery after maculaoff retinal detachments. Graefes Arch. Clin. Exp. Ophthalmol. 2002;240:85-9.
  23. Friberg T.R., Eller A.W. Prediction ofvisual recovery after scleral buckling of macula-off retinal detachments. Am.J. Ophthalmol. 1992;114:715-22.
  24. Tani P., Robertson D.M., Langworthy A. Prognosis for central vision and anatomic reattachment in rhegmatogenous RD with macula detached. Am.J. Ophthalmol. 1981;92:611-20.
  25. Zhigulin A.V., LebedevYa.B., Mashchenko N.V., Khudyakov A. Yu. Comparative efficacy of surgical treatment of idiopathic surgical treatment of macular rupture depending on its size using various methods of endovitreal tamponade. Cataract and refractive surgery. 2011; 11(1):41-3.
  26. Жигулин А.В., Лебедев Я.Б., Мащенко Н.В., Худяков А.Ю. Сравнительная эффективность хирургического лечения идиопатического хирургического лечения макулярного разрыва в зависимости от его размеров с помощью различных методов эндовитреальной тампонады // Катарактальная и рефракционная хирургия. 2011. Т. 11. № 1. С. 41-43.
  27. Burton T.C. Recovery of visual acuity after RD involving the macula. Trans. Am. Ophthalmol. Soc. 1982;80:475-97.
  28. Ross W.H., Kozy D.W. Visual recovery in macula-off rhegmatogenous retinal detachments. Ophthalmology. 1998;105:2149-53.
  29. Kreissig I. Prognosis of return of macular function after retinal reattachment. Mod. Probl. Ophthalmol. 1977;18:415-29.
  30. Hagimura N., Iida T., Suto K. et al. Persistent foveal retinal detachment after successful thegmatogenous retinal detachment surgery. Am.J. Ophthalmol. 2002;133:516-20.
  31. Lecleire-Collet A. Muraine M., Menard J.F. et al. Predictive visual outcome after macula-off retinal detachment surgery using optical coherence tomography. Retina. 2005;25:44-53.
  32. Gundry M.F., Davies E.W.G. Recovery of visual acuity after retinal detachment surgery. Am.J. Ophthalmol. 1974;77:310-4.
  33. Wilkinson C.P., Bradford R.H. Complications of draining subretinal fluid. Retina. 1984;4:1-4.
  34. Sabates N.R., Sabates F.N., Sabates R., et al. Macular changes after RD surgery. Am.J. Ophthalmol. 1989;108:22-9.
  35. Bonnet M, Bievelez B, Noel A, et al. Fluorescein angiography after retinal detachment microsurgery. Graefes Arch. Clin. Exp. Ophthalmol. 1983;221:35-40.
  36. Solyannikova O.V. Rhegmatogenous retinal detachment: clinical and instrumental studies and prognosis of treatment results. PhD Thesis. Chelyabinsk. 2001. 157 p.
  37. Солянникова О.В. Регматогенная отслойка сетчатки: клинико-инструментальные исследования и прогнозирование результатов лечения. Дис. канд. мед. наук. Челябинск, 2001. 157 с.
  38. Wolfensberger T.J. Foveal reattachment after macula-off retinal detachment occurs faster after vitrectomy than after buckle surgery. Ophthalmology. 2004;111:1340-3.
  39. Wakabayashi T, Oshima Y, Fujimoto H, et al. Foveal microstructure and visual acuity after retinal detachment repair: imaging analysis by Fourier-domain optical coherence tomography. Ophthalmology. 2009;116:519-28.
  40. Kiernan D.F., Mieler W.F., Hariprasad S.M. Spectral-domain optical coherence tomography: a comparison of modern high-resolution retinal imaging systems. Am.J. Ophthalmol. 2010;149:18-31.
  41. Nakanishi H., Hangai M., Unoki N., et al. Spectral-domain optical coherence tomography imaging of the detached macula in rhegmatogenous retinal detachment. Retina. 2009;29:232-2.
  42. Joe S.G., Kim Y.J., Chae J.B., et al. Structural recovery of the detached macula after retinal detachment repair as assessed by optical coherence tomography. Kor. J. Ophthalmol. 2013;27:178-85.
  43. Shimoda Y., Sano M., Hashimoto H., et al. Restoration of photoreceptor outer segment after vitrectomy for retinal detachment. Am.J. Ophthalmol. 2010;149:284-90.
  44. Avanesova T.A. Improving the clinical effectiveness of endovitreal treatment of rhegmatogenous retinal detachment based on the assessment of anatomical and morphological and microcirculatory parameters. PhD Thesis MD. Moscow. 2015. 139 c.
  45. Аванесова Т.А. Повышение клинической эффективности эндовитреального лечения регматогенной отслойки сетчатки на основе оценки анатомо-морфологических и микроциркуляторных показателей. Дисс. канд. мед. наук. Москва. 2015. 139 c.



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Copyright (c) 2020 Ilyukhin O.E., Frolov M.A., Ignatenko K.V.

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