A MULTIVARIATE ANALYSIS OF FACTORS AFFECTING PROGNOSTIC OUTCOME IN PATIENTS WITH RETINAL DETACHMENT TREATED WITH SCLERAL BUCKLING SURGERY
Journal Title: Journal of Evidence Based Medicine and Healthcare - Year 2018, Vol 5, Issue 9
Abstract
BACKGROUND Retinal detachment affects significant number of general population and needs procedures with profound surgical morbidity, certain times multiple procedures. High myopia, Ocular trauma, Ocular surgery, Family history and many other factors usually lead to Retinal detachment. As RD needs surgical correction with prognosis of Anatomical success in Reattachment and Functional recovery were dependent on various prognostic factors. Patient education on early symptoms of flashes and floaters especially in these high-risk groups is very important for them to seek early treatment which is the most crucial factor in prognosis of these patients. Moreover, appropriate referral by the General Ophthalmologist immediately on diagnosis to a Retinal Specialist is another time saver. Patients co morbid conditions affecting surgical fitness was also assessed, to see whether they were causing delay in surgery. Morphology of RD, Macular status, Nature of Breaks, SRF quality, Aphakic/Pseudophakic status were also evaluated against prognosis. MATERIALS AND METHODS This multivariate analysis was conducted at Retina services, Regional institute of Ophthalmology and Government Ophthalmic Hospital, Chennai for a period of 3 months. Thirty-five eyes of thirty-five patients were thoroughly evaluated with a proforma on History, presentation, seeking Eye treatment, Timing of Procedure following diagnosis, Co Morbid conditions and followed up with thorough ocular evaluation on Phakic status, Morphology of RD, Nature and number of breaks, Macular status, Signs of chronic RD like PVR, Mobility of retina etc. were analysed. All 30 patients were taken up for scleral buckling surgery. RESULTS Out of 30 patients in our series, 21 were males and 14 were females. The maximum patients in our series were in the age group between 19 to 57 years. We had fresh RD in 16 patients and chronic RD in 19 with the success rate better in the first group. 7 of our patients had multiple breaks which needed repeat surgical procedure for reattachment. Post-surgery our anatomical success rate was seen in 29 patients and good functional visual recovery of 6/18 or better was seen in 20 patients. The six patients who failed to attach post encirclage were taken for further Vitrectomy and silicone oil procedure. CONCLUSION Symptoms of Flashes and floaters and curtain in front of eye should be further disseminated very widely to the high-risk groups, especially their need to close an eye and check other eye by themselves at home regularly. In case they get these symptoms to immediately report to their Eye Doctor who can appropriately refer to an Retinal surgeon. Moreover, these patients also are susceptible for other eye problems and need constant followup to prevent similar attacks in another eye. And as RD family history is of significance their siblings also need periodic evaluation.
Authors and Affiliations
Rajasekar K, Sujatha R
Keywords
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- EP ID EP474138
- DOI 10.18410/jebmh/2018/155
- Views 81
- Downloads 0
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