Our Summary

This research paper reviews the current knowledge on persistent subretinal fluid (PSF) after successful surgery for rhegmatogenous retinal detachment (a serious eye condition where the retina separates from the back of the eye). The incidence rates of PSF after surgery vary significantly among studies, and it seems that one type of surgery (pars plana vitrectomy) may have lower rates of PSF compared to another (buckle surgery). Various causes and risk factors have been suggested, but none have been confirmed. In most cases, PSF gradually disappears on its own, a process that can take a while, without impacting the patient’s eventual vision. However, there are concerns that PSF could cause damage to the light-sensitive cells in the eye, displace the retina, or cause retinal folds. Currently, there’s no evidence to suggest that any particular treatment is better than just monitoring the condition in uncomplicated cases of PSF. The paper concludes by suggesting that well-designed, large-scale future studies could help better understand the incidence, causes, and consequences of PSF as well as the effectiveness of different treatments.

FAQs

  1. What is persistent subretinal fluid (PSF) following successful rhegmatogenous retinal detachment surgery?
  2. What are the potential risks or effects of PSF?
  3. Is there a preferred treatment option for cases of PSF?

Doctor’s Tip

One helpful tip a doctor might tell a patient about retinal detachment surgery is to follow post-operative instructions carefully, including avoiding strenuous activities or heavy lifting, as these actions can increase the risk of complications such as persistent subretinal fluid. It is important to attend all follow-up appointments with your doctor to monitor your recovery and address any concerns promptly.

Suitable For

Retinal detachment surgery is typically recommended for patients with rhegmatogenous retinal detachment, which is a type of retinal detachment caused by a tear or hole in the retina. This surgery is usually recommended for patients who have a high likelihood of achieving visual improvement or preventing further vision loss. Patients who are typically recommended for retinal detachment surgery include those with:

  • Acute symptoms of retinal detachment, such as sudden onset of floaters, flashes of light, or a curtain or shadow in their vision
  • A history of retinal tears or detachments in the other eye
  • High myopia (severe nearsightedness)
  • Previous eye surgery, such as cataract surgery
  • Trauma to the eye
  • Family history of retinal detachment
  • Older age, as the risk of retinal detachment increases with age
  • Certain eye conditions, such as lattice degeneration or retinoschisis.

It is important for patients to consult with an ophthalmologist to determine if retinal detachment surgery is the best course of action for their specific situation.

Timeline

Before retinal detachment surgery:

  1. Patient may experience symptoms such as sudden flashes of light, floaters, or a curtain-like shadow over their field of vision.
  2. Patient seeks medical attention and is diagnosed with a retinal detachment through a comprehensive eye examination.
  3. Preoperative tests and evaluations are conducted to determine the extent and severity of the detachment.

After retinal detachment surgery:

  1. Patient undergoes either scleral buckle surgery or pars plana vitrectomy to repair the detachment.
  2. In the immediate postoperative period, the patient may experience discomfort, blurry vision, and sensitivity to light.
  3. Over the following weeks to months, the patient’s vision gradually improves as the retina reattaches and the eye heals.
  4. Follow-up appointments with the ophthalmologist are scheduled to monitor the progress of the surgery and check for any complications.
  5. In some cases, patients may experience persistent subretinal fluid, which may gradually resolve over time without affecting final visual acuity.
  6. Long-term outcomes of retinal detachment surgery may include improved vision and prevention of further detachment episodes.

What to Ask Your Doctor

Some questions a patient should ask their doctor about retinal detachment surgery include:

  1. What are the possible risks and complications associated with retinal detachment surgery?
  2. What is the success rate of the surgery in reattaching the retina?
  3. How long is the recovery process expected to take?
  4. Will I need to follow any specific post-operative care instructions?
  5. What symptoms should I watch for that may indicate a complication or the need for further treatment?
  6. How soon after surgery can I expect to see improvements in my vision?
  7. Are there any restrictions on activities or behaviors I should follow after surgery?
  8. Will I need follow-up appointments or further treatments after the surgery?
  9. What is the likelihood of developing persistent subretinal fluid after the surgery, and what are the potential implications of this condition?
  10. Are there any alternative treatment options available for retinal detachment that I should consider?

Reference

Authors: Fouad YA, Habib AM, Sanders RN, Sallam AB. Journal: Semin Ophthalmol. 2022 Aug;37(6):724-729. doi: 10.1080/08820538.2022.2085516. Epub 2022 Jun 6. PMID: 35666630