Retinal detachment outcomes dependent on timely surgery

Timely emergency surgery for retinal detachments must be prioritised in eye care units, given the risk of permanent vision loss, and increased evidence of poorer outcomes for each day of delay, the 2025 Irish College of Ophthalmologists Annual Conference heard.

The remarks were made by Miss Miriam Minihan, Consultant Ophthalmic Surgeon, Moorfields Eye Hospital NHS Foundation Trust, London, UK.

Miss Minihan gave an overview of practices and data from the vitreoretinal department at the hospital, specifically about the management of acute rhegmatogenous retinal detachment (RD).

While the urgency of prompt intervention for ‘macula-on’ RD is well-established, Miss Minihan noted a growing body of global evidence suggesting that delays in treating ‘macula-off’ cases can significantly reduce the success of surgery and lead to poorer visual outcomes – reinforcing the need for urgent repair in these cases as well.

She stressed the importance of vitreoretinal surgeons advocating for their patients by ensuring that their operating lists have the capacity to perform RD repair surgery for ‘macula-off’ RDs within one-to-three days of diagnosis, as well as same day for ‘macula-on’ RDs, where possible.

In an age of small-gauge vitrectomy with higher cut rates and wide-angle viewing systems, surgical success rates in many institutions continue to improve. However, the adage of ‘time is retina’ should encompass all acute RDs, Miss Minihan concluded.