Firt operation anatomic ucce and other predictor of potoperative viion after complex retinal detachment repair with vitrectomy and ilicone oil tamponade

PURPOE: To evaluate the role of firt operation anatomic ucce compared with ucce after reoperation and preoperative characteritic in achieving ambulatory viion (≥4/200) and good viion (≥20/100) after repair of complex retinal detachment with vitrectomy and ilicone oil tamponade. METHOD: A propective, obervational, multicenter tudy of patient who underwent vitrectomy with ilicone oil for retinal detachment aociated with cytomegaloviru necrotizing retiniti or a non–cytomegaloviru necrotizing retiniti etiology, including proliferative diabetic retinopathy, giant retinal tear, proliferative vitreoretinopathy, and ocular trauma. REULT: A higher rate of ambulatory viion wa achieved in the firt operation anatomic ucce cae, compared with the reoperation cae, for eye with cytomegaloviru necrotizing retiniti (72% v 50%, P < 0.01) and eye without cytomegaloviru necrotizing retiniti (51% v 38%, P = 0.04). For eye with cytomegaloviru necrotizing retiniti, preoperative ambulatory viion (RR = 2.3, P < 0.0001) and reoperation (RR = 0.4, P = 0.05) were independent predictor of potoperative ambulatory viion. For eye without cytomegaloviru necrotizing retiniti, preoperative ambulatory viion (RR = 4.0, p < 0.0001) and retinal detachment etiology (P = 0.02) were prognotic factor. Compared to eye with trauma, eye with giant retinal tear, proliferative vitreoretinopathy and proliferative diabetic retinopathy were 2.8 (P < 0.003), 2.2 (P = 0.01) and 1.6 (P = 0.17) time a likely to achieve potoperative ambulatory viion, repectively. Within the giant retinal tear group, a higher rate of ambulatory viion wa achieved in the firt operation anatomic ucce cae compared with the reoperation cae (66% v 31%, P = 0.03). Although not tatitically ignificant, imilar outcome occurred in the proliferative diabetic retinopathy (48% v 25%) and proliferative vitreoretinopathy group (54% v 45%). imilar prognotic relationhip were found for good viual acuity outcome. CONCLUION: Firt operation anatomic ucce, preoperative viual acuity, and giant retinal tear or proliferative vitreoretinopathy a the retinal detachment etiology are important factor that predict viual outcome.