Relationships between retinal break locations and the shapes of the detachments

Figures & data

Figure 1 Group 1: detachments that occurred in the temporal or nasal superior region and did not exceed 12 o’clock.

Notes: Gray regions show the shapes of detachments, and breaks are inside black regions or within 1 1/2 hours of the highest border of the detachment corresponding with Lincoff’s law. White spot is one example for corresponding break location. We drew this schema to correspond with the same schema from the original text of Lincoff and Gieser.¹⁴

Figure 2 Superior temporal or nasal detachments that did not exceed the inferior vertical midline.

Notes: These detachments were included in Group 1 (see Figure 1). The black regions show the corresponding patterns of breaks in this category, the gray regions show the shapes of the detachments with our original drawing according to data from Lincoff and Gieser.¹⁴

Figure 3 Group 2: shallow detachments that occurred in the inferior region.

Notes: Gray regions show the shapes of detachments of this category, and breaks inside black regions are corresponding pattern with Lincoff’s law. White spot is one example for corresponding break location. The breaks shown inside the black region and those corresponding to the more spread side at the 6 o’clock midline correspond with Lincoff’s law. Data from Lincoff and Gieser.¹⁴

Figure 4 Group 3(A): detachments intersecting 12 o’clock.

Notes: The breaks are shown inside the black region or within the triangle whose apex is at 12 o’clock and intersecting the corresponding equators. Gray regions show the shapes of detachments of this category, and breaks inside black regions are corresponding pattern with Lincoff’s law. White spot is one example for corresponding break location. Data from Lincoff and Gieser.¹⁴

Figure 5 Group 3(B): this category is used to classify the same eyes as in Group 3 according to our different criteria for the corresponding pattern.

Notes: The breaks inside the black region or between 10:30 and 13:30 correspond. Gray regions show the shapes of detachments of this category, and breaks inside black regions are corresponding pattern with Lincoff’s law. White spot is one example for corresponding break location. Data from Lincoff and Gieser.¹⁴

Figure 6 Group 4: symmetrical detachments.

Notes: Only breaks at 6 o’clock correspond. Gray regions show the shapes of detachments of this category, and white spot is one example for corresponding break location. Data from Lincoff and Gieser.¹⁴

Figure 7 Group 5: inferior bullous detachments.

Notes: Breaks in the superior region correspond. Gray regions show the shapes of detachments of this category, and breaks inside black regions are corresponding pattern with Lincoff’s law. White spot is one example for corresponding break location. Data from Lincoff and Gieser.¹⁴

Figure 8 Group 6: detachments across both the superior vertical and horizontal midlines.

Notes: The breaks on the sides of the 12 o’clock meridian of the lower detachment correspond. Gray regions show the shapes of detachments of this category, and white spot is one example for corresponding break location. Data from Lincoff and Gieser.¹⁴

Figure 9 Group 7: almost total detachment except for a superior wedge-shaped attachment.

Notes: The breaks within the periphery near the highest border correspond. Gray regions show the shapes of detachments of this category, and white spot is one example for corresponding break location. Data from Lincoff and Gieser.¹⁴

Figure 10 Group 8: total detachments.

Notes: The breaks between 10:30 and 13:30 correspond. Gray regions show the shapes of detachments of this category, and breaks inside black regions are corresponding pattern with Lincoff’s law. White spot is one example for corresponding break location. Data from Lincoff and Gieser.¹⁴

Table 1 Subjects

First operative method		Age (years)	P-value
Buckling	681 eyes	48.8±16.4	<0.00001
Vitrectomy (with or without cataract surgery)	323 eyes	59.1±9.7
Another procedure	20 eyes
Total	1,024 eyes	50.6±27.7

Note: Statistical analysis was performed using Welch’s t-test.

Table 2 Corresponding numbers between the original text and our present study

	Original text in 1971^Citation14	Our present study	P-values
Superior temporal or nasal detachments (Group 1) (Figures 1 and 2)	98% (275/279 eyes)	92% (172/187 eyes)	P=0.001
Inferior shallow detachments (Group 2) (Figure 3)	95% (145/153 eyes)	86% (128/148 eyes)	P=0.012
Detachments across 12 o’clock	93% (315/340 eyes)	70% (279/398 eyes)	P<0.00001
The original hole was within the triangle whose apex was at 12:00 and intersected the equators as shown in the schema in the original text (Group 3[A]) (Figure 4)
Detachments across 12 o’clock	93% (315/340 eyes)	89% (353/398 eyes)	P=0.067
The original hole was within 1 1/2 hours of 12:00 or from 10:30 to 1:30 in own criteria (Group 3[B]) (Figure 5)
Detachments from breaks at 6 o’clock (Group 4) (Figure 6)	Exact number unknown	33% (1/3 eyes)
Inferior bullous detachments (Group 5) (Figure 7)	Exact number unknown	83% (45/54 eyes)
Across the superior vertical midline and both horizontal midlines (Group 6) (Figure 8)	Exact number unknown	100% (1 eye)
Almost total detachment except for a superior wedge-shaped attachment (Group 7) (Figure 9)	Exact number unknown	100% (1 eye)
Total detachments (Group 8) (Figure 10)	106/120 (87%)	56% (9/16 eyes)	P=0.00085
Cannot be classified or details unclear	–	152
Total	1,000	1,024

Note: Statistical analysis was performed using chi-squared test with or without Yate’s continuity correction.

Table 3 Refractive error in the present study (only phakic eyes and those that never underwent previous cataract surgery; moreover, those in which the macula remained attached before the operation)

	The median refractive error (D)	The corresponding rate		P-values
Superior temporal or nasal detachments (Group 1) (Figures 1 and 2) (n=70)	−3.08±3.66	Above −6 D (51/70 eyes)	98% (50/51 eyes)	P 0.729 =
		Under −6 D (19/70 eyes)	100% (19/19 eyes)
Inferior shallow detachments (Group 2) (Figure 3) (n=56)	−5.30±3.41	Above −6 D (29/56 eyes)	86% (25/29 eyes)	P 0.065 =
		Under −6 D (27/56 eyes)	100% (27/27 eyes)
Detachments across 12 o’clock (n=143) (Group 3[B]) (Figure 5)	−4.31±4.30	Above −6 D (101/143 eyes)	94% (95/101 eyes)	P 0.567 =
		Under −6 D (42/143 eyes)	95% (40/42 eyes)
Total (only phakic eyes and patients in whom the macula remained attached) (n=338)	−3.87±4.28	Above −6 D 136 of 338 eyes (only phakic eyes with an attached macula) Under −6 D 302 of 338 eyes (only phakic eyes with an attached macula)

Notes: Statistical analysis was performed using Fisher’s exact test or chi-squared test with Yate’s continuity correction. Group 1: superior temporal or nasal detachments. Group 2: inferior shallow detachments. Group 3: detachments intersecting the 12 o’clock superior vertical midline.

Table 4 Previous cataract surgery before rhegmatogenous retinal detachment and agreement rates

	Previous cataract surgery	Agreement rate	P-values
Superior temporal or nasal detachments (Group 1) (Figures 1 and 2)	Phakic (never underwent cataract surgery before the operation)	93% (142/153 eyes)	<img>
	Eyes that previously underwent cataract surgery without posterior capsule rupture	89% (16/18 eyes)
	With posterior capsule rupture or aphakia	100% (4/4 eyes)
Inferior shallow detachments (Group 2) (Figure 3)	Phakic	87% (108/124 eyes)
	Underwent cataract surgery without rupture	87% (7/8 eyes)
	Rupture or aphakia	83% (5/6 eyes)
Detachments across 12 o’clock (Group 3[B]) (Figure 5)	Phakic (never underwent cataract surgery before the operation)	89% (301/338 eyes)
	Underwent cataract surgery without rupture	97% (35/36 eyes)
	Rupture or aphakia	100% (7/7 eyes)

Notes: Statistical analyses were performed using Fisher’s exact test or chi-squared test with Yate’s continuity correction. Group 1: superior temporal or nasal detachments. Group 2: inferior shallow detachments. Group 3: detachments intersecting the 12 o’clock superior vertical midline.

Table 5 The results of previous studies according to Lincoff’s report

	Yoshioka et al^Citation19	Hanselmayer^Citation20
Temporal or nasal superior detachment	Partially allowed within 2 hours 95% (92/97 eyes)	Within 2 hours 93% (156/158 eyes) Within 1 hour 57% (96/158 eyes)
Inferior detachment	Within 2 hours around the 1/2 hour below the superior edge 92% (60/65 eyes)	Within 2 hours of the midline of detachments 80% (59/74 eyes) Within 1 hour 62% (46/74 eyes)
Detachment across 12 o’clock	Within 1 o’clock from 11:30 or 12:30, or within 1 1/2 hours from 11:30 or 12:30, or 1/2 hour from 12 o’clock, or between 11:00 and 1:30 92.8% (142/153 eyes)	Within 2 hours from 12 o’clock 77% (108/140 eyes) Within 1 hour from 12 o’clock 69% (97/140 eyes)

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