Absorption of Sub-Retinal Fluid Under-Macula after Scleral Buckling Surgery for Rhegmatogenous Retinal Detachment on Optical Coherence Tomography

Abstract

Objective: To determine the incidence of sub-macular fluid by Optical Coherence Tomography (OCT) and its clinical consequences on visual acuity after apparently successful scleral buckling surgery in uncomplicated macula-off, rhegmatogenous retinal detachment. Study Design: Prospective observational cohort series. Material and Methods: This study was conducted at Institute of Ophthalmology, Mayo Hospital Lahore from February 2011 to July 2012. Total 54 patients of age above 20 years with uncomplicated, macula-off, rhegmatogenous RD of less than 1 month duration were selected after fulfilling inclusion and exclusion criteria. After informed consent, all patients underwent scleral buckling surgery with or without  intra-operative external drainage, and followed for complete clinical examination especially for visual acuity and OCT scan of the macula at 1^st, 2^nd, 3^rd,and 6^th month postoperatively to detect the presence of sub-macular fluid and to establish its association with visual acuity. Results: Out of total 54 patients 3 left follow-up after surgery due to unknown reasons. Follow-up data of 51 patients was recorded, out of which only 7(13.7%) clinically had sub-macular fluid 1 month after surgery but OCT showed 22(43%) cases having sub-macular fluid. At 1^st follow-up visit (after 1 month) 10(19.6%) patients and at last follow-up visit (after 6 months) 20(39.2%) patients attained the best corrected visual acuity of 6/12 or better. Total 10(50%) out of 20 patients, who got final VA of 6/12 or better, had macular detachment for duration of less than 7 days. Conclusions: Sub-macular fluid on OCT was found to be directly associated with delayed visual recovery. Postoperative evaluation of persistent sub-macular fluid can be done more efficiently by OCT. Sub-macular fluid after SB surgery may persist for many months, and can cause delayed visual recovery. Key Words: Ocular Coherence Tomography(OCT), Rhegmatogenous Retinal Detachment, Sub-retinal Fluid.