title: Persistent subretinal fluid after surgery for rhegmatogenous retinal detachment: hypothesis and review.
abstract: BACKGROUND
  Persistent subretinal fluid after rhegmatogenous retinal detachment (RRD) surgery is responsible for delayed recovery, and may affect the final visual outcome. Cause, consequences, and treatment remain elusive.
  
  
  METHODS
  Literature review and case series.
  
  
  METHODS
  We reviewed the pathophysiological principles and therapeutic options from the literature, and we report the results from a subretinal fluid cytology study. Nine eyes from nine patients with macula-involving RRD underwent surgical repair. The cellular content of subretinal fluid (SRF) was studied by electron microscopy and anti-rhodopsin immunostaining. All eyes were assessed postoperatively with optical coherence tomography for the detection of persistent submacular fluid (PSF) (Ethics Committee Ghent University Hospital, registration number B6702006169).
  
  
  RESULTS
  Certain patient characteristics as well as surgical methods were implicated. PSF appears to occur more frequently in patients with longstanding detachments treated with buckling surgery. Several therapeutic options have been suggested but safety and efficacy remain unclear. We found PSF in three eyes on postoperative OCT scans, which corresponded to the three cell-rich subretinal samples.
  
  
  CONCLUSIONS
  PSF after successful RRD repair seems to be related to fluid composition. We hypothesize, in the absence of an effective treatment, that a modified surgical drainage, including a washout of the subretinal space, could evacuate the subretinal fluid more completely, and may prevent this complication.
authors.affiliation: Rotterdam Eye Hospital, Vitreoretinal Surgery, Schiedamse vest 180, 3000LM Rotterdam, the Netherlands.
authors.forename: M
authors.initials: M
authors.lastname: Veckeneer
authors.forename: L
authors.initials: L
authors.lastname: Derycke
authors.forename: E W
authors.initials: EW
authors.lastname: Lindstedt
authors.forename: J
authors.initials: J
authors.lastname: van Meurs
authors.forename: M
authors.initials: M
authors.lastname: Cornelissen
authors.forename: M
authors.initials: M
authors.lastname: Bracke
authors.forename: E
authors.initials: E
authors.lastname: Van Aken
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D004322:Drainage; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D046529:Microscopy, Electron, Transmission; D008875:Middle Aged; D011183:Postoperative Complications; D012163:Retinal Detachment / Q000503:physiopathology / Q000601:surgery*; D012243:Rhodopsin / Q000378:metabolism; D012374:Rod Cell Outer Segment / Q000378:metabolism / Q000648:ultrastructure*; D012591:Scleral Buckling; D058471:Subretinal Fluid / Q000166:cytology*; D041623:Tomography, Optical Coherence; D014792:Visual Acuity / Q000502:physiology; D014821:Vitrectomy
chemical_list: D012243:Rhodopsin