BILATERAL EYE PATCHING MAY IMPROVE CLINICAL OUTCOMES FOR ACUTE PRIMARY RHEGMATOGENOUS RETINAL DETACHMENT : RETINA

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BILATERAL EYE PATCHING MAY IMPROVE CLINICAL OUTCOMES FOR ACUTE PRIMARY RHEGMATOGENOUS RETINAL DETACHMENT

Tang, Peter H. MD, PhD*,†,‡; Curran, Christian D. MD†; Salman, Ali R. MD*; Sodhi, Guneet S. MD*; Vagaggini, Tommaso MD*; Haq, Zeeshan MD*; Mittra, Robert A. MD*,†; Dev, Sundeep MD*; Emerson, Geoffrey G. MD, PhD*,†; Parke, D. Wilkin III MD*,†; Quiram, Polly A. MD, PhD*; Belin, Peter J. MD*; Sastry, Ananth MD§; Ryan, Edwin H. MD*,†

Author Information

*Retina Consultants of Minnesota, Edina, Minnesota;

†Department of Ophthalmology and Visual Neurosciences, University of Minnesota Medical School, Minneapolis, Minnesota;

‡Department of Ophthalmology, Storm Eye Institute, Medical University of South Carolina, Charleston, South Carolina; and

§Department of Ophthalmology, Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio.

Reprint requests: Peter H. Tang, MD, PhD, Storm Eye Institute, Medical University of South Carolina, 167 Ashley Avenue, MSC 676, Charleston, SC 29425; e-mail: [email protected]

C. D. Curran is supported by a research fellowship provided by the VitreoRetinal Surgery Foundation. E. H. Ryan and D. W. Parke receive royalties from Alcon Inc, and Vortex Surgical, Inc, respectively.

Presented at the Retina Society Annual Meeting, New York, NY, October 14, 2023.

E. H. Ryan receives royalties for licensed patents from Alcon, Inc. D. W. Parke receives royalties for licensed patents from Vortex Surgical, Inc. None of the remaining authors has any financial/conflicting interests to disclose.

Retina 44(4):p 591-600, April 2024. | DOI: 10.1097/IAE.0000000000004004

Purpose: 

Evaluate preoperative bilateral eye patching (BEP) on subretinal fluid and vision in acute primary rhegmatogenous retinal detachments (RRDs).

Methods: 

Retrospective nonrandomized interventional study of 335 patients with RRD undergoing BEP until surgery (BEP cohort) and separated by the percentage of full-time compliance: high (≥90%), medium (>90% but ≥50%), and low (<50%). Those declining BEP were included (control). All underwent surgery and were followed for ≥3 months. Imaging was obtained immediately before surgery. Best-corrected visual acuity was measured at the longest follow-up and immediately before surgery. SRF and foveal status immediately before surgery were analyzed.

Results: 

Two hundred and forty and 95 patients were in BEP and control cohorts, respectively. Thirty patients presented immediately before surgery for analysis. High (64%) and medium (35%) compliance showed significantly greater (P < 0.01) SRF reduction compared with low (4%) and control (3%). Mac-off RRD showed significantly greater (P < 0.01) foveal reattachment with high (29%) and medium (8%) compliance compared with low (2%) and control (1%). Mac-on RRD demonstrated no significant differences (P ≥ 0.51) in final best-corrected visual acuity among high (0 logarithm of the minimum angle of resolution [logMAR] [median], 20/20 Snellen), medium (0.10 logMAR, 20/25 Snellen), low (0.10 logMAR), and control cohorts (0.10 logMAR). Mac-off RRD demonstrated significantly better final best-corrected visual acuity with high compliance (0.30 logMAR, 20/40 Snellen) compared with low (0.40 logMAR, 20/50 Snellen; P = 0.04) and control (0.60 logMAR, 20/80 Snellen; P = 0.02).

Conclusion: 

Preoperative BEP can stabilize or improve subretinal fluid in acute primary RRD. Patients with BEP >50% of the time experienced the greatest benefits.

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