Our Summary
This research paper is a study on the occurrence of metamorphopsia, a condition that distorts vision, in patients who have had surgery for a specific type of retina detachment (rhegmatogenous retinal detachment) where the macula, a part of the eye necessary for sharp vision, is also detached. The surgery involved removing the vitreous, a gel-like substance inside the eye, and replacing it with silicon oil.
Out of 50 patients who successfully underwent this procedure, more than half (27 patients) experienced metamorphopsia after the surgery. The study found that patients were more likely to experience this visual distortion if there was a delay of more than a week between the onset of symptoms and the surgery, if more than half of the retina was detached, and if the patient had an advanced stage of a secondary eye disease (proliferative vitreoretinopathy).
The study also used imaging techniques to look at the structures in the eye after surgery. It found that patients who had folds in the macula or displacement of the macula were significantly more likely to experience metamorphopsia.
In simpler terms, this study found that distorted vision is a common problem after surgery for a specific type of retina detachment and is more likely to occur if the surgery is delayed, if a large part of the retina is detached, or if the patient has an advanced eye disease. The presence of folds or displacement in the macula, a part of the eye important for sharp vision, also increases the likelihood of experiencing distorted vision after surgery.
FAQs
- What is the prevalence of metamorphopsia in patients who underwent surgery for rhegmatogenous retinal detachment (RRD)?
- What factors were found to be associated with the occurrence of metamorphopsia after surgery for RRD?
- What are the main causes of metamorphopsia after a successful retinal reapplication surgery?
Doctor’s Tip
A helpful tip a doctor might tell a patient about retinal detachment surgery is to report any symptoms or changes in vision promptly and to follow all post-operative care instructions carefully to optimize healing and minimize the risk of complications such as metamorphopsia. It is also important to attend all follow-up appointments to monitor for any potential issues and address them early on.
Suitable For
Patients who are typically recommended retinal detachment surgery are those with rhegmatogenous retinal detachment (RRD) with detached macula, who have successful surgery with durable anatomic reapplication of the retina after silicone oil tamponade. Patients with factors such as a delay in surgery, multiple detached quadrants, and stage C proliferative vitreoretinopathy may be at higher risk for postoperative metamorphopsia. Imaging findings such as macular folds and displacement may also be associated with the occurrence of metamorphopsia after surgery.
Timeline
Before surgery: The patient may experience symptoms such as flashes of light, floaters, and a sudden onset of blurry vision. They may also notice a shadow or curtain-like effect in their peripheral vision, indicating a possible retinal detachment. The patient will undergo a thorough eye examination and imaging tests to confirm the diagnosis of retinal detachment.
Day of surgery: The patient will undergo pars plana vitrectomy to reattach the detached retina. Silicone oil tamponade may be used to support the reattached retina during the healing process.
Post-operative day 1: The patient will be examined to check for any immediate complications or issues following surgery.
Post-operative day 7: The patient will undergo a follow-up examination to monitor the healing process and assess visual acuity.
Post-operative 1 month: The patient will undergo further examinations, including Amsler grid testing, fundus biomicroscopy, SD-OCT, and FAF imaging to assess the structural abnormalities and overall health of the retina.
Post-operative 3 months: The patient will have a final follow-up examination to evaluate the long-term success of the surgery and address any lingering visual issues, such as metamorphopsia.
Overall, the timeline for a patient before and after retinal detachment surgery involves thorough evaluation, surgical intervention, and post-operative monitoring to ensure successful reattachment of the retina and optimal visual outcomes. Metamorphopsia, or distorted vision, may be a common complaint following surgery and can be caused by factors such as macular rotation and folds, which can be detected through imaging tests.
What to Ask Your Doctor
- What is the success rate of retinal detachment surgery in patients with detached macula?
- How long is the recovery period after retinal detachment surgery?
- How will my vision be affected after the surgery?
- What are the potential complications or risks associated with retinal detachment surgery?
- Will I need any additional treatments or follow-up appointments after the surgery?
- How can I prevent future retinal detachments?
- Are there any lifestyle changes I should make to improve my eye health?
- What can I expect in terms of visual acuity and quality of vision after the surgery?
- Will I need to use any special eye drops or medications post-surgery?
- How soon can I resume normal activities, such as driving and exercise, after retinal detachment surgery?
Reference
Authors: Zgolli H, Abdelhedi C, Choura R, Abdaoui M, Fekih O, Zghal I, Nacef L. Journal: Tunis Med. 2023 Feb 11;101(2):280-284. PMID: 37682273