title: Scleral buckling surgery after macula-off retinal detachment: worse visual outcome after more than 6 days.
abstract: OBJECTIVE
  To determine the effect of duration of macular detachment (DMD) on visual acuity (VA) in patients with macula-off rhegmatogenous retinal detachment (RD).
  
  
  METHODS
  Retrospective observational case series.
  
  
  METHODS
  Two hundred two consecutive patients (202 eyes) with primary uncomplicated macula-off RD, preoperative VA of 10/100 or worse, a precise history of when macular function was lost, successful reattachment surgery, and a minimal follow-up of 3 months.
  
  
  METHODS
  All RDs were repaired with a primary scleral buckling procedure performed by 3 vitreoretinal surgeons.
  
  
  METHODS
  Visual acuity (best corrected and 3, 6, and 12 months postoperatively).
  
  
  RESULTS
  Considering all eyes, the cumulative mean of the best-corrected postoperative VA (logarithm of the minimum angle of resolution [logMAR]) as a function of DMD shows a rapid worsening when DMD exceeds 6 days. Eyes were divided into 3 groups, corresponding to the DMD intervals immediate (within 10 days), delayed (11 days-6 weeks), and late (>6 weeks). Mean postoperative VAs (in logMAR) were 0.35+/-0.31 (between 20/40 and 20/50 Snellen equivalent) in eyes with DMD up to 10 days, 0.48+/-0.26 (20/60 Snellen equivalent) in the delayed group, and 0.86+/-0.30 (8/60 Snellen equivalent) in eyes with DMD longer than 6 weeks.
  
  
  CONCLUSIONS
  The cumulative mean of the best-corrected postoperative VA (logMAR) as a function of DMD shows a rapid worsening when DMD exceeds 6 days. Our results indicate that the scleral buckling procedure should be done preferably within a 7-day DMD.
authors.affiliation: Eye Research Institute Maastricht, Department of Ophthalmology, University Hospital Maastricht, Maastricht, The Netherlands. r.diederen@np.unimaas.nl
authors.forename: Roselie M H
authors.initials: RM
authors.lastname: Diederen
authors.forename: Ellen C
authors.initials: EC
authors.lastname: La Heij
authors.forename: Alfons G H
authors.initials: AG
authors.lastname: Kessels
authors.forename: Fleur
authors.initials: F
authors.lastname: Goezinne
authors.forename: Albert T A
authors.initials: AT
authors.lastname: Liem
authors.forename: Fred
authors.initials: F
authors.lastname: Hendrikse
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012160:Retina / Q000503:physiopathology*; D012163:Retinal Detachment / Q000503:physiopathology* / Q000601:surgery*; D012189:Retrospective Studies; D012591:Scleral Buckling / Q000379:methods*; D013997:Time Factors; D014792:Visual Acuity / Q000502:physiology*