Persistent detachment of the fovea after non-buckling repair of rhegmatogenous retinal detachment

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 retinopexy^8,9 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 …