Absorption of Sub-Retinal Fluid Under-Macula after Scleral Buckling Surgery for Rhegmatogenous Retinal Detachment on Optical Coherence Tomography

Hussain Ahmed Khaqan, Najam Iqbal Chaudhry, Sarfraz Latif, Muhammad Sohail Arshad, Qasim Lateef Chaudhry


Objective: To determine the incidence of sub-macular fluid by Optical Coherence Tomography (OCT) and its clinical consequences on visual acuity after apparently successful scleral buckling surgery in uncomplicated macula-off, rhegmatogenous retinal detachment. Study Design: Prospective observational cohort series. Material and Methods: This study was conducted at Institute of Ophthalmology, Mayo Hospital Lahore from February 2011 to July 2012. Total 54 patients of age above 20 years with uncomplicated, macula-off, rhegmatogenous RD of less than 1 month duration were selected after fulfilling inclusion and exclusion criteria. After informed consent, all patients underwent scleral buckling surgery with or without  intra-operative external drainage, and followed for complete clinical examination especially for visual acuity and OCT scan of the macula at 1st, 2nd, 3rd,and 6th month postoperatively to detect the presence of sub-macular fluid and to establish its association with visual acuity. Results: Out of total 54 patients 3 left follow-up after surgery due to unknown reasons. Follow-up data of 51 patients was recorded, out of which only 7(13.7%) clinically had sub-macular fluid 1 month after surgery but OCT showed 22(43%) cases having sub-macular fluid. At 1st follow-up visit (after 1 month) 10(19.6%) patients and at last follow-up visit (after 6 months) 20(39.2%) patients attained the best corrected visual acuity of 6/12 or better. Total 10(50%) out of 20 patients, who got final VA of 6/12 or better, had macular detachment for duration of less than 7 days. Conclusions: Sub-macular fluid on OCT was found to be directly associated with delayed visual recovery. Postoperative evaluation of persistent sub-macular fluid can be done more efficiently by OCT. Sub-macular fluid after SB surgery may persist for many months, and can cause delayed visual recovery. Key Words: Ocular Coherence Tomography(OCT), Rhegmatogenous Retinal Detachment, Sub-retinal Fluid.

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