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BackgroundTo gather information on the effect of postoperative face-down posturing following combined phacoemulsification and vitrectomy for macular hole surgery in order to assist in the design of a larger definitive study.MethodsThirty phakic patients with stage II-IV full-thickness macular hole had combined phacoemulsification and pars plana vitrectomy with internal limiting membrane peel and 14% perfluoropropane (C3F8) gas. At the conclusion of surgery, patients were randomised either to face-down posture or to no posture, for 10 days. The primary outcome was macular hole closure.ResultsThe macular hole was successfully closed in 93.8% of the face-down posture group and in all of the no-posture group. Mean visual improvement was 0.63 (SD=0.21) logMAR units in the face-down group and 0.53 (SD=0.22) in the no posture patients.ConclusionFollowing combined phacoemulsification and vitrectomy, postoperative face-down posturing appears to make little difference to the final anatomical or visual outcome. If we assume a success rate of 95% in the posturing arm, and that there is no difference between posturing and non-posturing, then 798 patients would be required to be 90% sure that the 95% confidence interval will exclude a difference of more than 5%. [ABSTRACT FROM AUTHOR]

ObjectiveThis was a pilot randomised controlled trial (RCT) to investigate the effect of post-operative face-down positioning on the outcome of macular hole surgery and to inform the design of a larger definitive study.MethodsIn all, 30 phakic eyes of 30 subjects with idiopathic full-thickness macular holes underwent vitrectomy with dye-assisted peeling of the ILM and 14% perfluoropropane gas. Subjects were randomly allocated to posture face down for 10 days (posturing group) or to avoid a face-up position only (non-posturing group). The primary outcome was anatomical hole closure.ResultsMacular holes closed in 14 of 15 eyes (93.3%; 95% confidence interval (CI) 68-100%) in the posturing group and in 9 of 15 (60%; 95% CI 32-84%) in the non-posturing group. In a subgroup analysis of outcome according to macular hole size, all holes smaller than 400 μm closed regardless of posturing (100%). In contrast, holes larger than 400 μm closed in 10 of 11 eyes (91%; 95% CI 58-99%) in the posturing group and in only 4 of 10 eyes (40%; 95% CI 12-74%) in the non-posturing group (Fisher's exact test P=0.02).ConclusionPost-operative face-down positioning may improve the likelihood of macular hole closure, particularly for holes larger than 400 μm. These results support the case for a RCT. [ABSTRACT FROM AUTHOR]

Aim Devise simplified formulae, using preoperative clinical data, to give risk estimates of (1) failure and (2) proliferative vitreoretinpathy (PVR) following primary retinal detachment repair by vitrectomy. Methods 641 patients were analysed as part of an RCT investigating use of 5-fluorouracil and low-molecularweight heparin. Treatment status had no effect on success rates and did not therefore form part of the analyses. Preoperative risk factors for surgical failure and for PVR within 6 months of retinal detachment surgery were identified, and a multiple variable logistic regression model developed. Further analyses were performed to devise a simple points system to produce risk estimates of failure. Results Three risk factors were related to failuredprevious lens extraction (p=0.046), grade C PVR (p=0.039) and extent of detachment (p<0.001). Three risk factors were also related to failure due to PVRdvitreous haemorrhage (p=0.088), grade C PVR (p=0.044) and extent of detachment (p<0.001). There was good agreement between risk estimates produced by the points system and those calculated directly using a multivariate regression model. The points-system model gave an area under the receiver operating characteristic curve of 0.658. The receiver operating characteristic curve for the PVR model gave an area under the curve of 0.8399 suggesting greater diagnostic value. Conclusions A simple points system may be used as a clinical guide to identify patients at higher risk of failure following retinal detachment repair by vitrectomy. This may help clinicians select appropriate surgical approaches and stratify cases in research and surgical training. [ABSTRACT FROM AUTHOR]

AimsThe aim of this study is to provide epidemiological data on the incidence, aetiology, management, and visual outcome in traumatic optic neuropathy (TON) in the UK.MethodsPatients with TON were identified prospectively by population-based active surveillance through the British Ophthalmic Surveillance Unit over a 2-year period with data obtained from an incident questionnaire and follow-up questionnaire sent to positive reporters.ResultsIncident and follow-up data were available on 121 and 97 (80%) patients, respectively. The minimum estimated incidence was 1.005 per million. Leading causes included falls (25.6%), road traffic accidents (RTAs) (21.5%), and assaults (20.7%). The median age was 31 years. There were 95 (78.5%) men. Presenting visual acuity (VA) was 6/60 or worse in 85 (70%) patients, with 43 patients (36%) with no perception of light. Associated injuries included 47 (39%) orbital wall fractures, 37 (31%) closed globe injuries, 23 (19%) ocular adnexal injuries, 23 (19%) skull fractures, and 18 (16%) intracranial bleeding. Sixty-five percent (75/116) received no acute treatment and 35% (41/116) received steroids and/or surgery. Of the treated group, 24% (8/33) and of the untreated group 20% (11/56) improved three lines or more of VA (P=0.61). Prompt ophthalmic examination (P=0.002), orbital fracture (P=0.046), high Glasgow Coma Scale (GCS) score (P=0.023), and poor initial VA (P=0.009) were associated with increased likelihood of treatment. Poor initial VA (P<0.001), orbital fracture (P=0.004), and significant head injury (P=0.038) were associated with poor visual outcome.ConclusionsThis study suggested that young men were at greatest risk of TON. We detected a trend towards conservative management of this condition in the UK. TON was associated with significant ocular, orbital, and head injuries that highlighted the need for multidisciplinary management. [ABSTRACT FROM AUTHOR]

ABSTRACT Aim To investigate the prevalence and causes of optic neuropathy, reported as epidemic in 1997, among secondary school students in Dar esc Salaam, Tanzania. Patients and methods First year students (n=10 892) from 63 secondary schools located within 30 km from the base hospital were interviewed and had a visual acuity (VA) screening test. Students failing the 6/12-line in either eye were defined as having "poor eyesight" and referred to the base hospital where an optometrist retested VA and refracted them. An ophthalmologist examined students with VA of 6/12 or worse in either eye and visual impairment was defined as VA of worse than 6/12 with best correction. Associations between optic neuropathy, socioeconomic status and educational results were investigated. Results Students' ages ranged from 12 to 22 (mean 15.2) years; 50.6% were male. The prevalence of optic neuropathy was 0.3 (SD 0.051)%. The condition affected older students and was associated with the family having fewer economic possessions (car, computer, television). Optic neuropathy accounted for 19/33 (58%) of bilateral visual impairment cases. No effect of the disease on educational performance was identified. Conclusion Optic neuropathy remains a significant problem in this population and can now be termed endemic rather than epidemic. Further research into its causes is required. [ABSTRACT FROM AUTHOR]

PurposeInflammation is a risk factor for scarring after trabeculectomy surgery. Mast cells are important mediators of inflammation and scarring in allergic eye disease. This exploratory project investigated the presence of mast cells in the conjunctiva of glaucoma patients having trabeculectomy surgery.MethodsConjunctival biopsies from glaucoma patients belonging to specific groups: medically treated glaucoma (M, n=6), repeat glaucoma surgery (S, n=8), and uveitic glaucoma (U, n=7). The control group (C, n=8) was retinal detachment patients undergoing repair surgery for the first time. Immunohistochemistry techniques stained for the presence of the intracellular mast cell enzyme tryptase.ResultsThe median mast cell tryptase-positive counts for all glaucoma groups (M, S, and U) ranged from 0.102–0.113 cells/mm2 compared to 0.064 cells/mm2 for group C. This was statistically significant comparing group S to group C (P=0.0063), but not when comparing groups U or M to group C. The mast cell tryptase-positive counts did not significantly differ among the groups.ConclusionsMast cell numbers were significantly increased in glaucoma patients who have previously undergone surgery (group S). Mast cell activity may contribute to the scarring process and the increased risk of excessive conjunctival scarring after trabeculectomy surgery. Further investigation needs to be performed to evaluate this potential role. [ABSTRACT FROM AUTHOR]

B-cell chronic lymphocytic leukemia (CLL), the most common leukemia in older adults, remains largely incurable and novel treatments are urgently required. We previously reported powerful pro-apoptotic actions of bezafibrate (BEZ) and medroxyprogesterone acetate (MPA) against Burkitts lymphoma cells. Here, we demonstrate that BEZ and MPA individually, and more potently when combined (BEZ+MPA), induce apoptosis of unsorted and CD19+ve-selected CLL cells and abrogate the pro-proliferative activity of CD40L. This action was tumor cell specific, as the drugs had little impact on normal donor cells. The antiproliferative actions of BEZ+MPA were associated with the generation of reactive oxygen species (ROS), and the proapoptotic actions were associated with the generation of both ROS and mitochondrial superoxide (MSO). BEZ increased prostaglandin D2 (PGD2) synthesis by CLL cells, and treatment with PGD2 and its antineoplastic derivative 15dΔ12,14,PGJ2 recapitulated BEZ-induced antiproliferative and proapoptotic actions. The PGD2 receptor antagonist, BW868C, did not block BEZ or PGD2 activity against CLL cells. The potency of BEZ+MPA against CLL cells mirrored that of chlorambucil, and BEZ+MPA combined with chlorambucil was more potent than either treatment alone. Given the known safety profiles of BEZ and MPA, our data warrant further investigation of their potential as novel therapy for CLL.Leukemia (2009) 23, 292–304; doi:10.1038/leu.2008.283; published online 16 October 2008 [ABSTRACT FROM AUTHOR]

This work reports on advanced remanence and coercivity measurements undertaken on a set of perpendicular exchange-coupled composite (ECC) media, where the demagnetizing field, HD, has been properly accounted for. We find that, on correction, the shape of the hysteresis loop, and hence the shape of the remanence curve, changes significantly. More importantly, the value of the measured remanent coercivity, Hcr, is reduced by between 10 and 15% when the correction for HD is implemented. Measurements of the remanence, Mr, indicate that the normalized Mr /Ms varies strongly in the uncorrected case as the thickness of the soft layer increases, whereas for the corrected case, Mr/Ms is almost constant, around 0.82 ± 0.03. From the data obtained, we have also been able to determine the reversal processes that take place in both the hard and soft layers. Above a soft layer thickness of ∼12 nm, Mr/Ms becomes dominated by the HD. Insight has also been gained into the exchange coupling between the soft and hard layers for a low Ms soft layer. [ABSTRACT FROM AUTHOR]

The time-resolved magnetization dynamics of epitaxial Fe[sub3]O[sub4] ultra-thin films grown on GaAs were investigated for the first time using a field pumped TRMOKE (time-resolved magneto-optical Kerr effect) setup. The dynamic response of the sample to the field pulse was measured for different DC bias fields applied along two orthogonal crystalline directions for 3 and 6 nm films. The results show a heavily damped precessional response to the applied field pulses. By fitting the Landau-Lifshitz-Gilbert equation to the data the temporal evolution of the magnetisation can be reproduced and the damping constant determined to be around 0.1. [ABSTRACT FROM AUTHOR]

Thyroid carcinoma cells often do not express thyroid-specific genes including sodium iodide symporter (NIS), thyroperoxidase (TPO), thyroglobulin (TG), and thyrotropin-stimulating hormone receptor (TSHR). Treatment of thyroid carcinoma cells (four papillary and two anaplastic cell lines) with histone deacetylase inhibitors (SAHA or VPA) modestly induced the expression of the NIS gene. The promoter regions of the thyroid-specific genes contained binding sites for hepatocyte nuclear factor 3 beta (HNF3 beta)/forkhead box A2 (FoxA2), thyroid transcription factor 1 (TTF-1), and CCAAT/enhancer binding protein (C/EBP beta). Quantitative reverse transcription-polymerase chain reaction (RT-PCR) showed decreased expression of HNF3 beta/FoxA2 and TTF-1 mRNA in papillary thyroid carcinoma cell lines, when compared with normal thyroid cells. Forced expression of these genes in papillary thyroid carcinoma cells inhibited their growth. Furthermore, the CpG island in the promoter region of HNF3 beta/FoxA2 was aberrantly methylated; and treatment with 5-aza-2-deoxycytidine (5-Az) induced its expression. Immunohistochemical staining showed that C/EBP beta was localised in the nucleus in normal thyroid cells but was detected in the cytoplasm in papillary thyroid carcinoma cells. Subcellular fractionation of papillary thyroid carcinoma cell lines also demonstrated high levels of expression of C/EBP beta in the cytoplasm, suggesting that a large proportion of C/EBP beta protein is inappropriately localised in the cytoplasm. In summary, these findings reveal novel abnormalities in thyroid carcinoma cells. [ABSTRACT FROM AUTHOR]

Aim: To assess the results of primary aponeurotic ptosis surgery among UK ophthalmic oculoplastic surgeons, from both the surgeon's and patient's perspective; also to inform and encourage good clinical practice by generating outcomes for individual surgeons, units and for bench- marking purposes. Methods: A prospective, web-based, non-comparative, interventional study was conducted over a period of 1 year commencing January 2005 and ending December 2005. The data-entry sheet for the preoperative, operative and postoperative data was completed and submitted online via the British Oculoplastic Surgery Society website. Surgical results were assessed objectively (by the surgeon) by measuring the upper lid margin reflex distance (uMRD) and the interlid difference in: MAD, lid show, skin crease and lid contour with the outcome graded as: success, partial success or failed. Surgical results were also assessed subjectively (by the patient) with the outcome graded as: completely satisfied, significantly improved, no change or worse than before the operation. Results: Three hundred and sixty-five patients under- going primary aponeurotic ptosis repair, from 40 different consultant-led teams with a declared oculoplastic interest and expertise, originating from 27 units across the UK were entered into the study. Using objective criteria, success was achieved in 128/223 (57%) cases, with significantly greater degrees of success seen in patients with mild ptosis and for surgeons who performed ptosis surgery more frequently. Using subjective criteria, 184/ 282 (65%) of patients were completely satisfied, with a further 89/282 (32%) judging themselves significantly improved. The patients' assessment of the surgery was less critical than that of the surgeons: 46/1 38 (33%) of patients who were completely satisfied and 37/72 (51%) of those who were significantly improved did not meet the criteria for a successful surgical outcome. The reoperation rate was 8/313 (2.6%). Conclusions: The authors have generated a valid series of surgical outcomes both for individuals, units and the UK as a whole, expressed in both objective and subjective terms for what we regard as the signature procedure for an oculoplastic surgeon: aponeurotic ptosis surgery. Individual results have been communicated to our members, which will allow them to compare their results with true peer-group-generated figures and will aid appraisal and ultimately revalidation. [ABSTRACT FROM AUTHOR]

Aim: To evaluate outcome following retinectomy surgery and to identify factors that predict visual outcome. Methods: This was a retrospective uncontrolled interventional case-series of patients who underwent retinectomy surgery at Moorfields Eye Hospital (London, UK) during a 2-year period. We recorded pen-operative factors with the potential to influence functional outcome including aetiology of retinal detachment; type of ocular trauma; preoperative visual acuity and intraocular pressure; grade of PVR; extent and position of retinectomy; pen-operative complications; tamponade agent and prophylactic 3600 laser retinopexy. Results: The authors identified 145 patients who underwent retinectomy surgery. After a mean follow-up period of 23.2 months (6-58 months) 16% of eyes had visual acuity of 20/60 or better, 33% had visual acuity of between 20/60 and 20/400, and 51% had visual acuity less than 20/400. Visual acuity was improved or stable in 76% of eyes and the rate of complete retinal reattachment was 68%. For each stepwise increase in the grade of PVR there was an approximately 15% increased risk of final visual acuity of less than 20/40. The use of additional 360 degree prophylactic laser retinopexy prior to removal of silicone oil was associated with a higher rate of final retinal reattachment. Conclusions: This study provides important information to help surgeons inform and counsel their patients about visual prognosis following retinectomy surgery. Furthermore, the study demonstrates that the aetiology of retinal detachment, the stage of PVR and the use of 360° laser retinopexy have significant predictive value for visual outcome. Summary: Retinectomy is a valuable technique in the management of complex retinal detachment but is associated with a significant risk of retinal redetachment and poor visual outcome. In this large study, we identified that the aetiology of retinal detachment, the stage of proliferative vitreoretinopathy and the use of 360° prophylactic laser retinopexy are predictive of functional outcome. [ABSTRACT FROM AUTHOR]

Aim: To determine if repeated intravitreal triamcinolone improves best corrected visual acuity at 1 year compared with conventional laser therapy for persistent diabetic macular oedema. Methods: 88 eyes with persistent clinically significant macular oedema, after at least one prior laser photocoagulation, were included in this prospective randomised controlled trial. 43 patients were randomised to 4 mg of intravitreal triamcinolone (TA) and 45 to laser photocoagulation. The primary endpoint was the proportion of patients who improved by 15 Early Treatment of Diabetic Retinopathy Study (ETDRS) letters at 12 months in TA versus laser groups. Secondary endpoints were the change in mean best corrected visual acuity, difference in macular thickness and macular volume and adverse event reporting in particular elevated intraocular pressure at 12 months. Results: Improvement in ≥15 ETDRS letters occurred in two of 42 patients in the TA group (4.8%) and in five of 41 (12.2%) patients in the laser group (p = 0.265). At baseline, the mean ETDRS scores at baseline were 54.4 letters in the TA group and 53.0 letters in the laser group. At 12 months, these were 54.5 and 54.6, respectively. Optical coherence tomography showed a reduction in central macular thickness of 82.0 μm with TA and 62.3 μm with laser at 12 months. There was one case of sterile endophthalmitis. 22 out of 43 patients in the triamcinolone group required ocular antihypertensives. Conclusion: This study did not show a benefit from intravitreal triamcinolone over conventional laser therapy for patients with chronic diabetic macular oedema. [ABSTRACT FROM AUTHOR]

Objective: To study the preoperative characteristics, complications and outcomes of vitrectomy for proliferative diabetic retinopathy and to identify any factors that may predict visual outcome. Methods: Prospective study of 174 consecutive vitrectomies in 148 patients, with a minimum follow-up of 4 months. Results: 41(27.7%) patients had a vision of <6/60 in their better eye at presentation. Posterior retinal breaks occurred in 47(27.0%) eyes. Postoperative complications included vitreous cavity haemorrhage in 37(22.0%) eyes, retinal detachment in five eyes (3.0%), and rubeotic glaucoma in five eyes (3.0%). 124 (74.7%) eyes improved by at least 0.3 L0gMAR units, and 15 (9.0%) worsened by at least 0.3 L0gMAR units. 119 (71.7%) eyes had a visual acuity of 6/60 or better, and 27(16.3%) were counting fingers or worse. Only 16 (11.1%) patients had a vision of <6/60 in both eyes at latest follow-up. Preoperative vision in both the operated eye and the contralateral eye, macular detachment, and long-acting intraocular tampo- nade were independent predictors of poor postoperative vision, but this model accounted for only a small proportion of the observed variation in outcomes. Conclusions: Major complications are rare after vitrectomy for proliferative diabetic retinopathy, and >70% of eyes will regain vision of 6/60 or better. Visual outcomes remain unpredictable. [ABSTRACT FROM AUTHOR]

Background/aims: To investigate the association of biometric and systemic variables with optic disc characteristics in Chinese Singaporean adults. Methods: Ocular, biometric and medical data including intraocular pressure, refractive error, keratometry, axial length IAL), anterior chamber depth, corneal and lens thickness as well as optic disc data (using planimetry of stereo-photographs) were obtained from 622 normal subjects aged ~4O years from the Tanjong Pagar glaucoma survey of Singapore. Results: Disc area (DA) was positively associated with AL and height but was unrelated to corneal thickness. Following adjustment for lOP and sex, DA remained positively associated with AL, height and age. Neuroretinal rim area )RA) was also significantly and positively associated with AL and also with height. RA was negatively associated with lOP and was unrelated to blood pressure, history of diabetes, myocardial infarction, stroke or migraine. Conclusions: These data on a Chinese Singaporean population identify height and axial length of the globe as significantly associated with rim area of the disc. These features should be taken into account in statistical assessments of optic nerve head morphometry. This may improve the discriminative ability of image analysis to detect glaucomatous changes. In addition, we identified a statistically significant but small inverse association between rim area and lOP within the normal statistical range. [ABSTRACT FROM AUTHOR]

Background/aims: To investigate the correlation between optic disc parameters and their association with demographic variables in a Chinese population. Methods: Disc data were obtained from 929 subjects aged ~`4O years from the Tanjong Pagar glaucoma survey of Singapore, using a novel planimetric method of sequential stereo-photographs. Biometric data (refractive error, keratometry, axial length, anterior chamber depth, lens thickness) were used to calculate ocular magnification. Camera magnification was quantified with a model eye. A "normal" dataset of 622 subjects was generated by exclusion of subjects with abnormal results on psychophysical testing, an occludable angle or an intraocular pressure >97.5th percentile in either eye. Results: Median disc area (DA), cup area (CA), and rim area (IRA) were 2.09 (range 1.28-4.01) mm2, 0.69 (0.01- 1.90) mm2 and 1.38 (0.82-2.50) mm2, respectively. There was strong evidence of an association between DA and RA (Spearman's rho 0.624, p<0.001(. DA and RA were significantly greater in men (median DA = 2.20; range 1.30-3.56; median RA, 1.45; range 0.85-2.30) than women (median DA, 2.00; range 1.28-4.01; median RA, 1.36; range 0.82-2.49, pwomen(. Disc area (but not that of the rim) increases with age. [ABSTRACT FROM AUTHOR]

AimTo report on the agreement of macular hole size as measured using optical coherence tomography (OCT), Topcon digital photography, and surgeon estimate on clinical examination.MethodsObservational cohort series of patients who underwent macular hole surgery over an 18-month period. Patients had OCT scan and digital fundus photographs preoperatively. At operation the surgeon estimated the size of macular hole. The agreement between methods was assessed using the technique described by Bland and Altman.ResultsThere was good repeatability of photographic and OCT assessment and no evidence of systematic bias between repeated macular hole measurement by digital photography (P=0.36) or by OCT (P=0.58). There was evidence of systematic bias between photographic and surgeon measurements (P<0.001), and between OCT and surgeon (P<0.001) with photographic and OCT assessment being greater. There was also evidence of bias between OCT and photographic measurements with photographic measurement tending to be greater than the OCT measurement for smaller holes and lower for larger holes (P=0.02).ConclusionsOCT and Topcon digital photography have good repeatability for measurement of macular hole size. Both these methods measured larger hole sizes compared to surgeon estimate. Digital photography and OCT methods did not agree.Eye (2008) 22, 87–90; doi:10.1038/sj.eye.6702947; published online 28 September 2007 [ABSTRACT FROM AUTHOR]

Objective: To determine the efficacy of a combination of 5-fluorouracil (5FU) and low-molecular-weight heparin (LMWH) in the treatment of unselected rhegmatogenous retinal detachment (RRD) undergoing primary vitrectomy. Design: Double-masked, prospective, randomized, placebo-controlled clinical trial. Participants: Six hundred forty-one patients presenting with primary RRD were recruited from 2 specialized vitreoretinal units—Moorfields Eye Hospital, London (n = 553) and St. Pauls Eye Unit, Liverpool (n = 88). Intervention: All patients underwent primary vitrectomy and gas endotamponade. Adjuvant therapy in the treatment group consisted of 5 IU/ml LMWH and 200 μg/ml 5FU added to the perioperative infusion fluid. Main Outcome Measures: The primary outcome measure was retinal reattachment after primary vitrectomy without any reoperations at 6 months. Secondary outcome measures recorded at 6 months were the occurrence and grade of proliferative vitreoretinopathy (PVR), best-corrected visual acuity in logarithm of the minimum angle of resolution, intraocular pressure (mmHg), corneal clarity, and complications. Results: The overall primary success rate was 84.4%; in the treatment group, the primary success rate was 82.3% compared with 86.8% in the placebo group (P = 0.12). At 6 months, the final complete anatomical reattachment rate was 97.9% in both treatment and placebo groups. The number of patients who failed due to the development of PVR was not statistically significant, 23 in the treatment group (7.0%) and 14 in the placebo group (4.9%) (P = 0.309). There was no significant difference in the mean visual acuity at 6 months in the placebo group (0.48) versus the treatment group (0.53; P = 0.072). The visual acuity at 6 months of patients presenting with a macula-sparing retinal detachment was significantly worse in the treatment group (P = 0.0091). There was no significant difference between the 2 groups in patients who presented with a macula involving retinal detachment (P = 0.896). Conclusions: Primary vitrectomy has a high anatomic and visual success rate for RRD. Adjuvant therapy with 5FU and LMWH does not improve the anatomic or visual success rate of unselected primary retinal detachments undergoing vitrectomy. After adjuvant therapy, a worse visual outcome was observed in patients presenting with macula-sparing retinal detachments. A combination of 5FU and LMWH should not be used routinely for primary RRD surgery. [Copyright &y& Elsevier]

PurposeTo determine factors associated with anatomical and functional outcomes of macula-off retinal detachment surgery in a modern vitreoretinal unit.MethodsA retrospective casenote review of 185 patients presenting with macula-off retinal detachment was performed. Demographic and ocular characteristics were determined. Logistic regression analysis was used to determine (1) the effect of these factors on visual outcome and (2) their effect on primary and final anatomical success.ResultsPrimary and ultimate anatomical success were achieved in 76 and 84% of cases. Patients with oil in at final follow-up were considered to be anatomical failures. Statistically significant factors predicting primary anatomical success using a multiple variable model were preoperative logMAR visual acuity, preoperative PVR and number of breaks. Preop logMAR visual acuity and duration of macular detachment were the statistically significant factors predicting ultimate success. In all, 44% of patients regained 6/12 Snellen or better with a median improvement of 0.78 logMAR. For prediction of visual outcome (in patients with no ocular comorbidity) only preoperative logMAR visual acuity achieved statistical significance (P=0.001) at the P=0.05 level.ConclusionIn all, 76% of macula-off detachments may be repaired with one operation and 44% of patients regain at least 6/12 Snellen. The median logMAR acuity increment of 0.78 far exceeds that seen in cataract surgery. Preoperative visual acuity is the most important factor predicting primary and final anatomical success as well as visual outcome. Preoperative PVR, number of breaks and duration of detachment also affect outcomes.Eye (2007) 21, 534–540. doi:10.1038/sj.eye.6702260; published online 3 February 2006 [ABSTRACT FROM AUTHOR]