title: The effect of duration of macular detachment on results after the scleral buckle repair of primary, macula-off retinal detachments.
abstract: OBJECTIVE
  To present a current series that determined the effect of duration of macular detachment (DMD) and patient age on postscleral buckle (SB) visual acuity (VA) and anatomic results.
  
  
  METHODS
  Retrospective, noncomparative, observational case series.
  
  
  METHODS
  Ninety-four consecutive patients (94 eyes) with primary, uncomplicated, macula-off retinal detachments, a preoperative VA of 20/200 or worse, and a precise history of when macular function was lost.
  
  
  METHODS
  Standard explant scleral buckle technique performed by multiple surgeons.
  
  
  METHODS
  Visual acuity, anatomic reattachment, and proliferative vitreoretinopathy.
  
  
  RESULTS
  Visual acuity after SB of 20/40 or better was seen in 71% of eyes with a DMD of 10 days or fewer, 27% of eyes with a DMD of 11 days to 6 weeks, and 14% of eyes with a DMD of more than 6 weeks. Eyes achieved a mean VA after SB of 20/41 after a DMD of 10 days or fewer, 20/121 after a DMD of 11 days to 6 weeks, and 20/178 after a DMD of more than 6 weeks. No decrease in VA was seen within the 1- to 10-day period or the 11 days to 6 week period of DMD. Patients 60 years of age or less achieved a mean VA after SB of 20/47 compared with 20/81 for patients between 61 to 75 years of age and 20 of 96 in patients more than 76 years of age. Duration of macular detachment and patient age had no statistically significant effect on final anatomic reattachment after SB, reoperation rate, or proliferative vitreoretinopathy.
  
  
  CONCLUSIONS
  Eyes with primary, uncomplicated, macula-off retinal detachment repaired with SB achieve excellent postoperative VA if repaired within the first 10 days of macular detachment. These results are better than the VA in eyes repaired after 11 days to 6 weeks and more than 6 weeks of macular detachment. Patients 60 years of age and younger obtained better postoperative VA than older patients. Duration of macular detachment and patient age did not significantly effect anatomic outcomes.
authors.affiliation: Associated Retinal Consultants, PC, the Department of Ophthalmology, William Beaumont Hospital Eye Institute, 3535 West 13 Mile Road, Royal Oak, MI 48073, USA.
authors.forename: Tarek S
authors.initials: TS
authors.lastname: Hassan
authors.forename: Ramin
authors.initials: R
authors.lastname: Sarrafizadeh
authors.forename: Alan J
authors.initials: AJ
authors.lastname: Ruby
authors.forename: Bruce R
authors.initials: BR
authors.lastname: Garretson
authors.forename: Barbara
authors.initials: B
authors.lastname: Kuczynski
authors.forename: George A
authors.initials: GA
authors.lastname: Williams
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008266:Macula Lutea / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012163:Retinal Detachment / Q000503:physiopathology / Q000601:surgery*; D012189:Retrospective Studies; D012591:Scleral Buckling; D013997:Time Factors; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology