The following is the summary of “A paradigm shift in retinal detachment repair: The concept of integrity” published in November 2022 issue of Retinal and Eye by Muni, et al.

Rhegmatogenous retinal detachment treatment has advanced dramatically in the last few decades. As a result, retinal reattachment can be accomplished with a variety of surgical procedures. In addition, retinal imaging technology has come a long way in recent years, allowing for unique visualization and research of retinal macro- and microstructural anatomy after retinal detachment repair.

Recent clinical trial data shows that anatomic biomarkers of retinal recovery or “integrity” correlate with differences in functional and patient-reported results of retinal reattachment. In addition, recent discoveries about the physiology of retinal reattachment, made possible by multimodal imaging, have shed light on the pathophysiology of numerous anatomic anomalies that might occur after surgery. The best case scenario is prompt retinal reattachment without retinal displacement, outer retinal folds, or discontinuity of the external limiting membrane, ellipsoid zone, and interdigitation zone, and with an unharmed foveal bulge. Their goal is to provide the vitreoretinal surgeon with a comprehensive, up-to-date description of the principles and mechanisms now used during retinal reattachment surgery, including evidence from clinical data and mathematical modeling.

In this study, researchers provide supporting evidence for a paradigm change away from a focus on single-operation reattachment rates toward a concentration on maximizing functional outcomes by minimally invasive procedures in treating rhegmatogenous retinal detachment. Vitreoretinal surgeons can achieve this goal by utilizing a wide variety of methods, tailoring each patient’s surgery to their specific needs, and maintaining a firm focus on improving the “integrity” of retinal reattachment.