Retinal Displacement Following Rhegmatogenous Retinal Detachment: A Systematic Review and Meta-Analysis

  • Ryan H. Mason
    Affiliations
    Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, ON, Canada

    Department of Ophthalmology, St. Michael's Hospital/Unity Health, Toronto, ON, Canada

    Kensington Vision and Research Centre, Toronto, ON, Canada
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  • Samuel A. Minaker
    Affiliations
    Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, ON, Canada

    Department of Ophthalmology, St. Michael's Hospital/Unity Health, Toronto, ON, Canada

    Kensington Vision and Research Centre, Toronto, ON, Canada
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  • Samara B. Marafon
    Affiliations
    Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, ON, Canada

    Department of Ophthalmology, St. Michael's Hospital/Unity Health, Toronto, ON, Canada
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  • Natalia Figueiredo
    Affiliations
    Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, ON, Canada

    Department of Ophthalmology, St. Michael's Hospital/Unity Health, Toronto, ON, Canada
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  • Roxane J. Hillier
    Affiliations
    Newcastle Eye Centre, Royal Victoria Infirmary, Newcastle-Upon-Tyne, United Kingdom

    Translational and Clinical Research Institute, Newcastle University, United Kingdom
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  • Rajeev H. Muni
    Correspondence
    Corresponding Author: Rajeev H. Muni, MD, MSc, FRCSC, Department of Ophthalmology, St. Michael's Hospital/Unity Health Toronto, 8th floor, Donnelly Wing, St. Michael's Hospital, 30 Bond St., Toronto Ontario, M5B 1W8
    Affiliations
    Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, ON, Canada

    Department of Ophthalmology, St. Michael's Hospital/Unity Health, Toronto, ON, Canada

    Kensington Vision and Research Centre, Toronto, ON, Canada

    University of Toronto/Kensington Health Ophthalmology Biobank, Cytokine and Imaging Laboratory, Toronto, Canada
    Search for articles by this author

      ABSTRACT

      Retinal displacement following rhegmatogenous retinal detachment (RRD) repair is an important consideration when assessing the integrity of reattachment, with potential implications on functional outcomes. There are limited data comparing various surgical techniques. We conducted a review of retinal displacement following RRD repair through October 2021, finding twenty-one studies encompassing 1258 unique eyes. Outcome measures included the frequency of retinal displacement, visual acuity, metamorphopsia, and displacement direction. A meta-analysis was performed with data reported as risk ratios or mean difference and 95% confidence intervals. Retinal displacement was found in 35±20% of RRD repairs. Scleral buckle (SB) without tamponade had the lowest rate of retinal displacement (9.60 [2.01-45.95], p=0.005), followed by pneumatic retinopexy (PnR) and finally pars plana vitrectomy (PPV). Silicone oil may reduce risk of displacement following PPV compared to gas (2.16 [1.22-3.83], p=0.009), as may immediate face-down positioning for 2 hours. Retinal displacement following PPV occurred in the downward direction in 92±14% of cases and does not appear to significantly impact visual acuity (0.05 [-0.21-0.31 p=0.70), although it may increase distortion. SB, PnR, PPV with silicone oil, and immediate face-down positioning are likely associated with less retinal displacement. Additional prospective studies are required to increase the certainty of these findings.

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