Retinal folds following retinal detachment surgery.

PURPOSE To review the occurrence of macular retinal folds following retinal detachment surgery. METHOD Review of the literature. RESULTS Macular folds have been reported in up to 3% of cases postoperatively. Risk factors are tamponading gas bubble, large exoplants, detachments with bullous configuration or running through the fovea, and incomplete drainage of subretinal fluid. Preventive measures include correct posturing and avoidance of modifiable risk factors. The natural history is variable. Complete resolution as well as persisting folds with permanent structural damage have been reported. Treatment indications and techniques remain controversial. Very few successful reports of surgical correction have been published to date. CONCLUSIONS Macular folds are a serious but underreported complication of retinal detachment surgery that can be avoided in the majority of cases. Macular folds can be prevented by correct posture and avoiding large exoplants, large tamponade bubbles and incomplete drainage of subretinal fluid.