# Grading retinal displacement after retinal detachment repair: a prospective study linking displacement grade and visual outcome

## TL;DR

This study shows that retinal displacement after surgery for retinal detachment is linked to worse vision, with a new grading system helping predict outcomes.

## Contribution

A novel grading system for retinal displacement was introduced and shown to correlate with visual outcomes.

## Key findings

- Retinal displacement was more frequent after vitrectomy compared to scleral buckle surgery.
- Higher displacement grades (2–3) were associated with significantly worse final visual acuity.
- Preoperative posterior vitreous detachment (PVD) positively correlated with surgical success in vitrectomy cases.

## Abstract

To evaluate the impact of surgical technique, preoperative findings, and the degree of retinal displacement on visual outcomes in patients undergoing repair for rhegmatogenous retinal detachment (RRD).

In this prospective cohort study, all consecutive patients with RRD treated at Sheba Medical Center between March 2021 and March 2022 were included. Data on surgical techniques, visual acuity (VA), preoperative posterior vitreous detachment (PVD), and postoperative imaging were collected. Retinal displacement was graded based on fundus autofluorescence and correlated with visual outcomes.

A total of 128 eyes from 128 patients (mean age 56.7 ± 15.4 years) were analyzed. Pars plana vitrectomy (PPV) was the most common procedure (79.9%), followed by scleral buckle (SB, 18.8%) and pneumatic retinopexy (2.3%). Significant improvement in VA was observed across all surgical groups. Retinal displacement was more frequent following PPV (68%) compared to SB (16%). Higher displacement grades (2–3) were associated with significantly worse final VA (p = 0.024). The presence of preoperative PVD positively correlated with surgical success in the PPV group (p = 0.003). Early postoperative signs of displacement included retinal folds and photoreceptor changes.

Preoperative PVD status is a significant predictor of surgical success in PPV-treated RRD. Grading of retinal displacement offers a practical tool to assess its functional impact, with higher grades correlating with worse visual outcomes. Identifying risk factors for visually significant displacement may improve surgical decision-making and patient prognosis.

Retinal displacement is a known postoperative finding in patients undergoing pars plana vitrectomy (PPV) for rhegmatogenous retinal detachment (RRD).Scleral buckle surgery is associated with lower rates of retinal displacement compared to vitrectomy.

Retinal displacement is a known postoperative finding in patients undergoing pars plana vitrectomy (PPV) for rhegmatogenous retinal detachment (RRD).

Scleral buckle surgery is associated with lower rates of retinal displacement compared to vitrectomy.

A novel grading system for retinal displacement, based on vascular shift in the vertical foveal line, was introduced and shown to correlate with visual acuity outcomes.Preoperative posterior vitreous detachment (PVD) status significantly impacts surgical success, particularly in PPV cases.High-grade retinal displacement (grades 2–3) is associated with worse visual acuity following RRD repair.

A novel grading system for retinal displacement, based on vascular shift in the vertical foveal line, was introduced and shown to correlate with visual acuity outcomes.

Preoperative posterior vitreous detachment (PVD) status significantly impacts surgical success, particularly in PPV cases.

High-grade retinal displacement (grades 2–3) is associated with worse visual acuity following RRD repair.