Snellen visual acuities were converted to logMAR units to create a linear scale of visual acuity. The best corrected postoperative vision was determined by the referring ophthalmologist at a point 6 months post-surgery or beyond. The preoperative acuity was documented by the examining retinal surgeon.

Therefore, 100 patients remained with macula-off detachments of 7 days’ duration or less, who had no pre-existing ocular disease and had successful repair with one procedure. There were four primary failures, and these were also excluded from the study. One hundred and four patients remained, and all underwent surgical repair of detachments within 24 hours of initial examination. An additional 23 patients with macula-off detachments of less than 1 week’s duration were excluded because of previous retinal surgery (9 patients), proliferative vitreo-retinopathy more advanced than grade C3 in patients who had undergone initial combined vitrectomy and buckling surgery (4 patients), or ocular disease that precluded a good return of central vision (10 patients: macular degeneration in two, macular hole in two, degenerative myopia in two, optic atrophy in one, end-stage glaucoma in one, and amblyopia in two). Ninety-one patients had macula-off detachments of longer than 7 days’ duration and were excluded. The remaining 218 patients were carefully interviewed to pinpoint the onset of macular detachment to a specific 24-hour period within the first week. Eighty-five patients had macula-on detachments and were excluded from the study. In this prospective study, 303 consecutive patients with rhegmatogenous retinal detachments seen during a 30-month period (Augthrough January 31, 1997) were interviewed and examined to determine the status of macular detachment.

The purpose was to determine the visual results of macula-off retinal detachments operated on within 7 days of macular involvement. In 1998, Ross and Kozy 14 published an article to help clarify this question. Despite Burton’s results, it remained unknown whether surgical delay within the first week of macula-off retinal detachment altered final postoperative visual acuity. This study demonstrated that visual recovery in relation to increasing duration of detachment declines in an exponential fashion ( Figure 1).

After 4 weeks of macular detachment, approximately one line of vision was lost for each additional 10–11 days until 7 days. After day 5, the vision declined at a rate of one Snellen line per week up to 1 month.

The first break in his data occurred at day 5, at which the average level of visual recovery was 20/50. He concluded that patients with macular detachment of 9 days or less had a statistically significant better chance of obtaining a final vision of 20/50 or better than those with macular detachment of 10–19 days and longer than 20 days duration ( P < 0.05).īurton showed a progressive decline in visual acuity recovery over a 1–79 day period. The proportion attaining 20/20 to 20/50 acuity diminished to 34% (27/70) in those patients operated on from 10–19 days and to 29% (14/48) in those patients operated on after 19 days. He reported that 53% (46/87) of patients who underwent surgery by 9 days achieved 20/20 to 20/50 acuity. In 1982, Burton 10 published an important article on visual recovery of macula-off retinal detachments.

Recovery for detached retina surgery