Anatomical and Functional Outcomes of Tractional Retinal Detachment Surgery at Kilimanjaro Christian Medical Centre, Moshi, Tanzania (2024–2025)

Abstract

Aims: Assessment of clinical characteristics, efficacy of treatment, and pre-operative factors associated with the anatomical and functional outcome of patients who underwent tractional retinal detachment surgery at KCMC Study Design:  A hospital-based prospective cohort study. Place and Duration of Study: Sample: Department of Ophthalmology, KCMC hospital, between July 2024 to July 2025. Methodology: A total of 100 patients who underwent surgery for tractional retinal detachment (TRD) were included in the study. Data on sociodemographic and clinical characteristics were collected from patients who underwent TRD surgery. Statistical analyses were performed using Stata version 15 (StataCorp, College Station, TX), and GraphPad prism software was used to generate figures. Chi-square tests and logistic regression were used to assess associations between independent variables and surgical outcomes. Results were reported with a 95% confidence level, and statistical significance was set at p < 0.05. Results: The study included 100 patients, predominantly male (72%), with a median age of 55 years. Most patients presented late, with symptoms persisting for more than four weeks, and 80% had severe visual loss at presentation. Diabetes mellitus was the leading risk factor, present in over half of the cases. Floaters and flashes were the most common presenting symptoms. Pars plana vitrectomy with silicone oil tamponade achieved a higher anatomical success rate (68.9%) compared to gas tamponade (60%). Favorable surgical outcomes were significantly associated with good preoperative visual acuity (OR = 0.170; p = 0.002), local residency (OR = 5.750; p = 0.001), history of diabetes mellitus (OR = 4.000; p = 0.003), and silicone oil use (OR = 4.547; p = 0.001). Postoperative mean logMAR visual acuity improved significantly from 2.14 to 1.00 (p < 0.001). Macular status at presentation also influenced visual recovery. Conclusion: In this setting, tractional retinal detachment predominantly affected middle-aged males, often presenting at advanced stages due to delayed access to care. Silicone oil tamponade achieved superior anatomical success in complex cases. Early detection, especially among high-risk individuals, and timely intervention are crucial. As delays increase photoreceptor damage, subretinal fibrosis, and reduce the likelihood of successful retinal reattachment. Access to specialized eye-care services needs to be improved to reduce late presentation.