Preoperative and early postoperative factors associated with visual outcome after macular-off retinal detachment surgery.

Purpose: To evaluate preoperative and early postoperative factors associated with changes in visual acuity in macula-off rhegmatogenous retinal detachment (RRD) patients.

Methods: A retrospective review of 59 eyes from 59 patients who underwent pars plana vitrectomy (PPV) and silicone oil (SiO) tamponade for macula-off RRD. Preoperative and early postoperative characteristics were analyzed using the classification and regression tree (CART) analysis.

Results: The baseline preoperative BCVA improved from 1.67 ± 0.97 logMAR to 0.21 ± 0.22 logMAR at final visit. Central foveal thickness (CFT) and BCVA showed significant increases from 1 week post-surgery onward. Mean CFT significantly increased from 136.97 ± 40.17 μm to 192.54 ± 34.09 μm (p < 0.001). The percentage of eyes with integrated external limiting membrane (ELM) and ellipsoid zone (EZ) was progressively increased from 45.76% and 10.17% to 98.31% and 71.19%, respectively (p < 0.001). BCVA at 1week after surgery, ELM integrity, preoperative intraretinal cysts, and macula-off duration were significantly associated with final visual recovery after surgery.

Conclusion: The first week postoperative BCVA is the most powerful predictor for final BCVA. ELM integrity, intraretinal cysts, and macula-off duration are also significantly associated with final visual recovery.