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Predicting post-surgery change in visual acuity after successful repair of macula-off retinal detachments: findings from a large prospective UK cohort study

Eye volume 39, pages 2298–2306 (2025)Cite this article

Subjects

Abstract

Objective

To identify risk factors affecting the change in visual acuity in successfully re-attached macula-off rhegmatogenous retinal detachment (RD) surgery.

Design

A cohort study, using an online database, of visual outcomes for 2770 macula-off retinal detachments that were successfully re-attached by vitrectomy and internal tamponade. The database included detailed retinal diagrams of each detachment.

Main outcome measure

The change in LogMAR visual acuity from pre-operatively to post-operatively.

Results

Male patients accounted for 64.6% of the sample and the median age was 63 years old. The median pre-operative VA was counting fingers (LogMAR 1.98); this improved to 0.30 LogMAR post-operatively. An improvement in VA of ≥0.30 LogMAR was achieved by 88.0% eyes. The change in VA model identified the preoperative VA, patient age, duration of central vision loss, lens status at follow up, extent of detachment, and the number of breaks in the detached retina, as factors influencing the change in VA. The model had an adjusted R2 of 0.749, and for 75.5% of eyes, the model prediction was within ±0.30 LogMAR of the recorded VA change.

Conclusions

Greater post-operative visual acuity improvement was more likely in eyes that were pseudophakic at follow up, and had shorter durations of central vision loss. Non modifiable factors associated with greater vision improvement included worse presenting vision, younger age, less extensive detachment and less than three breaks in the detached retina. These results confirm that prompt surgery improves functional outcomes in successfully treated macula off retinal detachments irrespective of presenting visual acuity.

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Funding

Funding for statistical analysis was provided by the Britain & Eire Association of Vitreoretinal Surgeons. The design and development of the database software was funded by Euretina.

Author information

Author notes

  1. A list of members and their affiliations appears in the Supplementary Information.

Authors and Affiliations

  1. Gartnavel Hospital, Glasgow, UK

    David Yorston

  2. Gloucestershire Hospitals NHS Foundation Trust, Cheltenham, GL53 7AN, UK

    Paul H. J. Donachie

  3. The Royal College of Ophthalmologists’ National Ophthalmology Database Audit, London, UK

    Paul H. J. Donachie

  4. Guy’s and St. Thomas’ NHS Foundation Trust, London, UK

    D. A. Laidlaw & Tom H. Williamson

  5. Sunderland Eye Infirmary, Sunderland, UK and Bioscience Institute, Newcastle University, Newcastle Upon Tyne, UK

    David H. Steel

Authors
  1. David Yorston
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  2. Paul H. J. Donachie
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  3. D. A. Laidlaw
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  4. David H. Steel
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  5. Tom H. Williamson
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Consortia

members of the Britain & Eire Association of Vitreoretinal surgeons (BEAVRS) and Euretina Retinal Detachment Study Groups

Contributions

DY - original conception, design of study, first draft of manuscript. PD - statistical analysis. DAHL - revision of manuscript, design of study, interpretation of data. DS - revision of manuscript, design of study, interpretation of data. TW - revision of manuscript, design of study, interpretation of data.

Corresponding author

Correspondence to David Yorston.

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The authors declare no competing interests.

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Yorston, D., Donachie, P.H.J., Laidlaw, D.A. et al. Predicting post-surgery change in visual acuity after successful repair of macula-off retinal detachments: findings from a large prospective UK cohort study. Eye 39, 2298–2306 (2025). https://doi.org/10.1038/s41433-025-03752-y

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