Does unintentional macular translocation after retinal detachment repair influence visual outcome? Comment

Background:  To document the occurrence of postoperative macular translocation after retinal detachment repair and discuss its influence on visual outcome. Design:  Retrospective case series in a tertiary care setting. Participants:  Five eyes of five patients presenting to our clinic with macula-off rhegmatogenous retinal detachment. Methods:  All patients underwent surgical repair of the retinal detachment, with regular postoperative follow-up, including macular optical coherence tomography and fundus autofluorescence. Main Outcome Measures:  Visual acuity and subjective visual symptoms in patients with anatomically successful retinal detachment repair, in whom inadvertent macular translocation was noted. Results:  Our series demonstrates the presence of unintentional macular translocation after retinal detachment repair, detected by fundus autofluorescence imaging. In contrast to previous reports, we document inadvertent macular translocation in one patient after scleral buckling surgery. In each case, the retina was fully reattached postoperatively and no other complications were identified. There was variability in the symptoms and objective visual outcomes after surgery. Conclusions:  Inadvertent macular translocation can occur following repair of macula-off retinal detachment, and may be a significant contributor to poorer visual outcome after retinal detachment, despite objective surgical success.