Browse by author
Lookup NU author(s): Roxane Hillier
Full text for this publication is not currently held within this repository. Alternative links are provided below where available.
© 2022 Elsevier LtdThe management of rhegmatogenous retinal detachment has rapidly evolved over recent decades. A range of surgical techniques exist, all of which can achieve retinal reattachment in most cases. In recent years there have also been vast technical advances in retinal imaging that have introduced novel ways of visualizing and studying the retinal macro and microstructural anatomy following retinal detachment repair. Recent clinical trial data demonstrates that functional and patient-reported outcomes of retinal reattachment differ with surgical technique, accompanied by differences in anatomic biomarkers of retinal recovery or ‘integrity’. We discuss recent insights into the physiology of retinal reattachment gleaned from multimodal imaging, which shed light on the pathophysiology of various post-operative anatomic abnormalities. The ideal scenario is to achieve retinal reattachment as soon as possible, without retinal displacement, outer retinal folds or discontinuity of the external limiting membrane, ellipsoid zone and interdigitation zone, with an intact foveal bulge. To this end, we present an in-depth contemporary account of current concepts and mechanisms involved during retinal reattachment surgery, supported by clinical data and mathematical modelling, awareness of which can help the vitreoretinal surgeon achieve better post-operative outcomes. In this review we substantiate the case for a paradigm shift in rhegmatogenous retinal detachment repair; beyond the emphasis on single-operation reattachment rates, and instead striving to maximize functional outcomes using minimally invasive techniques. This can only be achieved if vitreoretinal surgeons embrace all of the available techniques, with individualized selection of surgical approach and the resolute goal of optimizing the ‘integrity’ of retinal reattachment.
Author(s): Muni RH, Lee WW, Bansal A, Ramachandran A, Hillier RJ
Publication type: Review
Publication status: Published
Journal: Progress in Retinal and Eye Research
Year: 2022
Volume: 91
Online publication date: 14/10/2022
Acceptance date: 17/05/2022
ISSN (print): 1350-9462
ISSN (electronic): 1873-1635
Publisher: Elsevier Ltd
URL: https://doi.org/10.1016/j.preteyeres.2022.101079
DOI: 10.1016/j.preteyeres.2022.101079
PubMed id: 36253216
