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Persistent detachment of the fovea after non-buckling repair of rhegmatogenous retinal detachment
  1. P Atmaca-Sonmez,
  2. M W Johnson,
  3. D N Zacks
  1. Retina Service, Kellogg Eye Center, University of Michigan, Ann Arbor, MI, USA
  1. Correspondence to: David N Zacks MD, PhD, Kellogg Eye Center, 1000 Wall Street, Ann Arbor, MI 48105, USA; davzacks{at}umich.edu

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Persistent detachment of the fovea is increasingly recognised as a cause of delayed visual recovery after repair of rhegmatogenous retinal detachment (RRD).1–6 Often subfoveal fluid cannot be seen on biomicroscopy or indirect ophthalmoscopy. It has only been the recent introduction of optical coherence tomography (OCT) into clinical practice that has allowed a more detailed study of this fluid. Persistent subfoveal fluid has primarily been reported after scleral buckling (SB) surgery,7 though it has been documented after pneumatic retinopexy8,9 and pars plana vitrectomy (PPV).10 The persistent fluid can be very subtle and difficult to detect on fundus examination. We report three cases of delayed visual recovery caused by persistent neurosensory macular detachment after non-scleral buckling procedures. Despite a normal appearing fundus, OCT confirmed the presence of persistent subretinal fluid.

Case report

A 58 year old myopic woman was referred for the treatment of a macula-off retinal detachment in the left eye. Her symptoms had begun 6 weeks earlier. Examination of the right eye was within normal limits. Best corrected visual acuity (BCVA) in the left eye was 20/400. Slit lamp examination (SLE) was unremarkable. Dilated fundus examination revealed a horseshoe retinal tear at 1 o’clock with macula-off temporal retinal detachment. Cryotherapy and pneumatic retinopexy with C3F8 gas were performed …

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