Quantification of cone loss after surgery for retinal detachment involving the macula using adaptive optics

{Aims To image the cones in eyes with anatomically successful repair of retinal detachment (RD) involving the macula and in healthy fellow eyes using an adaptive optics (AO) camera and to correlate the results to clinical outcomes. Methods Twenty-one patients (42 eyes) operated for macula-off RD were imaged 6 weeks after surgery using an AO camera (RTX 1, Imagine Eyes, Orsay, France). Cone density (cells/mm(2)), spacing between cells (mu m) and the percentage of cones with six neighbours were measured. Best-corrected visual acuity (BCVA) and thickness of the inner segment ellipsoid (ISe) band imaged by SD-optical coherence tomography were also measured. Results The parafoveal cone density was decreased in eyes operated for RD (mean +/- SD 14 576 +/- 4035/mm(2)) compared with fellow eyes (20 589 +/- 2350/mm(2)) (p=0.0001). There was also an increase in cone spacing (10.3 +/- 2.6 vs 8.0 +/- 1.0.9 mu m, respectively, p<0.0001). The nearest-neighbour analysis revealed a reduction in the percentage of cones with six neighbours (36.5 +/- 4.2 vs 42.7 +/- 4.6%