Predictive parameters for the functional outcome of pseudophakic retinal detachment surgery

Background. Pseudophakic retinal detachment is one of the most severe compl ications after cataract surgery and is a common cause of permanently reduce d visual acuity. We evaluated parameters predicting reduced functional outc ome by a model of stepwise regression analysis. Patients and methods. A series of 102 consecutive patients with pseudophaki c retinal detachment were analyzed for various parameters regarding catarac t surgery, retina I surgery and retinal detachment features. First, univari ate analysis determined the correlations with reduced functional outcome. S econdly, a stepwise regression model analyzed statistically significant var iables for their predictive value of a reduced visual outcome. Results. The overall reattachment rate was 99%. In 69% of the patients ther e was an improvement of more than two lines at the end of the follow-up per iod. The most predictive factors for reduced functional outcome were the ne ed for a silicone oil tamponade and the visual acuity prior to retinal deta chment surgery. When silicone oil tamponade was not needed, the requirement of more than two retinal surgeries was the most predictive factor for redu ced visual outcome. Conclusion. In our series the strongest predictive factors for a reduced fu nctional outcome were the necessity of silicone oil, reduced visual acuity at the time of retinal detachment, and the requirement of more than two ret inal surgeries. These findings suggest that first-line procedures should no t be necessarily minimally invasive measurements but rather procedures that result in a stably attached retina in the first instance without permanent silicone oil tamponade, even if this first operation consists of an extend ed pars plana vitrectomy.