Perioperative factors that are significantly correlated with final visual acuity in eyes after successful rhegmatogenous retinal detachment surgery

PURPOSE: To determine the perioperative factors that are significantly correlated with the final visual acuity following reattachment of a macula-off rhegmatogenous retinal detachment (RRD) by vitrectomy. METHODS: Twenty-nine eyes of 29 patients with a successfully reattached RRD by vitrectomy were retrospectively analyzed. Spectral-domain optical coherence tomographic images of the macular regions were used to measure the thicknesses of the retinal layers and the integrity of the microstructures of the photoreceptors at 2 weeks, 1, 2, 3, 6, 9, and 12 months following the vitrectomy. The best-corrected visual acuities (BCVA) were evaluated at the same times. RESULTS: The improvement of the BCVA from the preoperative BCVA to that at postoperative Week 2 (-0.67 ± 0.69 logMAR units) was the largest change between adjacent observation periods for the entire study duration. It was significantly greater than the improvement between Week 2 and Month 12 (-0.32 ± 0.22 logMAR units; P<0.001). The thickness of the ellipsoid zone (EZ)-retinal pigment epithelium (RPE) increased significantly with time (P<0.001). The final BCVA was significantly correlated with the BCVA at Week 2 (r = 0.61, P<0.001), the EZ-RPE thickness at Week 2 (r = -0.40, P = 0.035), the integrity of the external limiting membrane (ELM) (r = -0.61, P = 0.003), and an intact EZ (r = -0.66, P = 0.001) at Week 2. Multiple stepwise regression analyses of the final BCVA showed that the BCVA at Week 2 (P = 0.017) and the integrity of the EZ at Week 2 (P = 0.006) were independent predictors of the final BCVA. CONCLUSIONS: The significantly better BCVA and presence of an intact EZ at 2 weeks following vitrectomy and their significant correlations with the BCVA at Month 12 indicate that these perioperative values can be used to predict the BCVA at Month 12 after a reattachment of macula-off RRD following vitrectomy.