Rhegmatogenous retinal detachment (RRD) is an acute, sight threatening condition, with an incidence of approximately 10 per 100,000 people. Surgical interventions for treating RRD include pars plana vitrectomy (PPV), which currently represents the main adopted surgical choice. Main outcomes of successful RRD surgery have mainly been represented by anatomical retinal reattachment and best-corrected visual acuity (BCVA). Despite successful surgery, patients with mac-off RRD often report postoperative visual complaints of distortion such as metamorphopsia and scotomas in their central visual field, with great variability.
Major advances in retinal imaging including wide-field optical coherence tomography (OCT) and fundus autofluorescence (FAF) allowed to investigate morphological changes after RRD surgery. The concept of retinal displacement - where the retina has reattached but the exact location has shifted, as evidenced by retinal vessel printing shown on post operative retinal imaging.
Postoperative retinal displacement has been observed to occur with different frequency in relationship to variables including postoperative tamponade, surgical technique, and intraoperative use of perfluorocarbon liquids (PFCL). The investigators hope to formally study the impact of intraoperative use of PFCL, which is used as an aid during surgery to help flatten and position the retina, on retinal displacement. This will help us better understand the impact of this tool on outcomes both objectively through retinal imaging, and subjectively through visual outcomes including visual acuity and measures of distortion and other visual disturbances.
18 years of age, or older.
Diagnosis of primary MIRD with posterior vitreous detachment, and fovea off (confirmed with OCT)
Surgeons' decision that the patient is eligible for using gas as postoperative tamponade.
The surgeon is confident to proceed with surgery with or without the use of intraoperative PFCL
Previous RRD and/or RRD surgery in the study eye
Decision to use adjunct scleral buckle
Decision to use silicone oil as tamponade
Retinal detachment with macula on
Parallel
Perflurocarbon liquid
Procedure/SurgeryUsed to facilitate surgery of retinal detachment to stabilise macular during surgery.
Without Perflurocarbon liquid
Procedure/SurgeryStandard retinal detachment surgery (vitrectomy) without the use of Perflurocarbon liquid (PFCL).
Retinal Displacement
Number of patients with presence of retinal displacement on post operative retinal imaging (FAF) between groups with PFCL use and without PFCL use.
Best-Corrected Visual Acuity
Average change in visual acuity (BCVA) in groups with PFCL and without PFCL use
Metamorphopsia
Average M-CHARTS score comparison between groups with PFCL use and without PFCL use.
Quantification of retinal displacement
Retinal displacement distance as measured on retinal imaging (FAF) in millimetres.
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