[Retinal detachment by inferior tear: a poor prognosis?].

Aim: To determine whether a lower location of retinal wounds is a factor for poor prognosis in retinal detachment.
Patients and Method: This retrospective study involved 248 medical records of patients who were operated on for retinal detachment in 2001 at the Toulouse-Rangueil Hospital Ophthalmology Department. We excluded retinal detachment of very short-sighted patients, diabetic patients and detachment secondary to trauma or relapses. We compared the incidence of surgical failure according to various parameters: condition of the crystalline lens, operative technique, operator, vitreoretinal proliferation, retinal wound location, patient age and the operative side. Thirty-six patients presented with lower wounds; 17 patients obtained incomplete results and relapsed within 1 year of surgery.
Results: Vitreoretinal proliferation and inferior location of the retinal detachment were found to be poor prognostic factors. No significant differences were found between the other parameters studied.
Discussion: A variety of prognostic factors of retinal detachment surgery are now clearly identified (vitreoretinal proliferation, old detachment). A lower location of the detachment constitutes an additional difficulty for retinal applications. Indeed, it is more difficult to perform effective buffering in this type of case. We recommend that retinal detachment be operated internally, to reduce the risk of relapse.
Conclusion: An inferior location of the retinal wound during retinal detachment appears to be a factor of poor prognosis, but this remains to be ascertained through an ongoing, prospective study.