Bilateral eye patching may improve clinical outcomes for acute primary rhegmatogenous retinal detachment

Abstract

Abstract Purpose: Evaluate preoperative bilateral eye patching (BEP) on subretinal fluid (SRF) and vision in acute primary rhegmatogenous retinal detachments (RRD). Methods: Retrospective non-randomized interventional study of 335 RRD patients undergoing BEP until surgery (BEP cohort) and separated by % full-time compliance: high (≥ 90%), medium (> 90% but ≥ 50%), and low (< 50%). Those declining BEP were included (control). All underwent surgery and followed for ≥ 3 months. Imaging was obtained immediately prior to surgery (iPTS). Best-corrected visual acuity (BCVA) was measured at longest follow-up and iPTS. SRF and foveal status iPTS were analyzed. Results: 240 and 95 patients were in BEP and control cohorts, respectively. 30 patients presented iPTS for analysis. High (64%) and medium (35%) compliance showed significantly greater (P < 0.01) SRF reduction compared to low (4%) and control (3%). Mac-off RRD showed significantly greater (P < 0.01) foveal reattachment with high (29%) and medium (8%) compliance compared to low (2%) and control (1%). Mac-on RRD demonstrated no significant differences (P ≥ 0.51) in final BCVA among high (0 logMAR [median], 20/20 Snellen), medium (0.10 logMAR, 20/25 Snellen), low (0.10 logMAR), and control cohorts (0.10 logMAR). Mac-off RRD demonstrated significantly better final BCVA with high compliance (0.30 logMAR, 20/40 Snellen) compared to low (0.40 logMAR, 20/50 Snellen; P = 0.04) and control (0.60 logMAR, 20/80 Snellen; P = 0.02). Conclusions: Preoperative BEP can stabilize or improve SRF in acute primary RRD. Patients with BEP >50% of time experienced greatest benefits.