Post-vitrectomy maculopathy, or ``Why doesn't my retinal detachment patient see better?''

Retinal detachment (RD) is a surgical disease with good anatomical results thanks to advances in vitreo-retinal surgical techniques. However, in spite of good anatomical results, visual recovery may sometimes be clearly less satisfactory. These poor functional results may be due to epiretinal membranes, macular holes or macula edema, some of which may be transitory, and some of which may be amenable to surgical treatment. However, some circumstances can be explained only by an alteration of deep retinal layers, especially at the photoreceptor level. Newer OCTs (optical coherence tomography) can provide a more detailed in vivo anatomical assessment of the retina, to which microperimetry can add a functional perspective. Better understanding of poor prognostic factors (poor preoperative visual acuity, RD duration, height of the macular detachment) can improve the quality of information given to the patient. (C) 2014 Elsevier Masson SAS. All rights reserved.