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U. Kıvrak

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Open access 2026

Clinical and Surgical Predictors of Visual and Anatomical Outcomes Following Pars Plana Vitrectomy for Rhegmatogenous Retinal Detachment

Objective: To investigate the clinical and surgical factors affecting visual outcomes and recurrence rates following pars plana vitrectomy (PPV) for rhegmatogenous retinal detachment (RRD). Methods: This retrospective study included 226 patients who underwent PPV for RRD between 2022 and 2024 at a tertiary care center in Türkiye. Demographic data, duration of symptoms, macular status, presence of proliferative vitreoretinopathy (PVR), type of intravitreal tamponade, pre-and postoperative best-corrected visual acuity (BCVA), intraocular pressure (IOP), and recurrence rates were analyzed. Results: Patients had a mean age of 57.9±14.4 years and were predominantly male (67.7%); 76.5% were macula-off, and 25.7% had PVR. Mean BCVA improved significantly from 1.8±0.7 to 1.0±0.6 logMAR (p<0.001), with preoperative BCVA independently predicting postoperative BCVA ( β =0.185, p=0.003). Visual improvement was poorer in eyes with macula-off status (p=0.044) and preoperative PVR (p=0.046), better with earlier surgical intervention (<7 days; p=0.030), and greater with C3F8 tamponade than with other agents (p=0.043), while combined cataract surgery did not influence outcomes (p=0.917). IOP increased modestly from 13.9±3.9 to 15.3±3.9 mmHg (p<0.001); 17.3% of patients required antiglaucoma-tous therapy, more often with silicone oil (SO) tamponade (p=0.023), without affecting final BCVA (p=0.917). Recurrent RRD occurred in 18.6% of patients and was higher in those with PVR (39.7% vs. 11.3%; p<0.01). Multivariable analysis identified PVR as the only independent predictor of recurrence (OR=3.44, p=0.023), and recurrence was lower with C3F8 than with SO (11.1% vs. 24.1%; p=0.026). Conclusion: These findings underscore the importance of preserving macular attachment, minimizing surgical delay, and recognizing PVR as a key determinant of both functional recovery and recurrence in optimizing outcomes after PPV for RRD. ABSTRACT

Güzide Akçay, U. Kıvrak, I. Karagöz et al. · 0 citations
Open access Aug 2026

Clinical and morphological predictors of visual outcomes following inverted internal limiting membrane flap surgery for large macular holes

Purpose: The purpose of the study was to evaluate the anatomical and functional outcomes of the inverted internal limiting membrane (ILM) flap technique in patients with large macular holes (MHs) and identify independent prognostic factors that predict post-operative visual acuity. Methods: This retrospective study included 48 eyes of 48 patients who underwent pars plana vitrectomy and inverted ILM flap technique for idiopathic MHs ≥400 μm. Pre-operative and post-operative best-corrected visual acuity (BCVA), swept-source optical coherence tomography (SS-OCT) parameters, and various clinical factors were evaluated. Multivariate regression analysis was performed to identify independent prognostic factors for the post-operative BCVA. Results: The mean BCVA improved significantly from 1.27±0.41 logMAR preoperatively to 0.62±0.37 logMAR at 6 months postoperatively (p<0.001). U-shaped closure was associated with better BCVA than V-and W-shaped closures (p=0.001). Patients with symptom duration ≤6 months and complete post-operative restoration of the external limiting membrane (ELM) and ellipsoid zone demonstrated significantly better BCVA (p<0.01). Pre-operative BCVA (β=0.637, p<0.001) and MH index (MHI) (β=−0.261, p=0.029) were significant independent determinants of post-operative BCVA. Conclusion: The inverted ILM flap technique provides high anatomical closure rates and significant visual improvement in large MH surgery. Pre-operative BCVA and MHI were significant independent prognostic factors for post-operative visual outcomes. Structural SS-OCT parameters can be clinically useful in predicting post-operative functional outcomes

Güzide Akçay, Dilber Çelik Yaprak, U. Kıvrak et al. · 0 citations