Abstract
Retinectomy, essential for treating complex rhegmatogenous retinal detachment, significantly risks retinal displacement, detectable through fundus autofluorescence. This situation frequently results in substantial distortion of vision, underscoring the importance of addressing aspects of visual functionality beyond visual acuity.
Purpose:To assess the incidence and degree of retinal displacement after nonprimary retinectomy in macula-involving rhegmatogenous retinal detachment (RRD) complicated by proliferative vitreoretinopathy (PVR).Methods:A retrospective interventional case series was conducted on eyes that underwent a second surgery involving retinectomy for complex macula-involving RRD between December 2011 and September 2023 at the Bascom Palmer Eye Institute. Clinical records and imaging were analyzed to assess the incidence and degree of retinal displacement using postoperative fundus autofluorescence (FAF).Results:Ten eyes of 10 patients (mean age 63.67 years) with complex RRD were followed over an average period of 18.4 months. Postoperative FAF imaging, performed on average 6.32 ± 8.7 months after retinectomy, revealed retinal displacement in 70% of eyes (n = 7) with an average displacement measuring 0.52 ± 0.75 mm. Metamorphopsia was noted in two patients (20%) with retinal displacement. The best-corrected visual acuity improved from 1.62 logMAR before the second surgery to 1.20 logMAR by the last follow-up visit.Conclusion:Retinectomy in the setting of treatment for complex PVR-associated RRD carries a high risk of retinal displacement as measured by fundus autofluorescence. It is unclear how much retinal displacement affects visual outcomes, but it may contribute to postoperative visual acuity and metamorphopsia.