To determine the efficacy of using the preferential hyperacuity perimeter (PHP) for the analysis of metamorphopsia following macular-off rhegmatogenous retinal detachment (RRD) surgical repair.

PHP examination was performed in those who complained of metamorphopsia after successful surgical reattachment of RRD. The subjective symptoms were evaluated based on a scale, ranging from 0 to 10, and were compared with the results of PHP examination. Patients age, duration of retinal detachment, pre and post-operative visual acuity, postoperative presence of subretinal fluid (SRF), surgical methods, presence of epiretinal membrane, and time from operation to PHP test were analyzed to find the correlation with the PHP results.

Of the 19 eyes included in this study, nine eyes were found to have a hyperacuity defect upon PHP examination. In this group, the subjective level of metamorphopsia was significantly worse ( p <0.01), the age was significantly higher ( p =0.02), and SRF persisted in the macula more frequently at two months postoperatively ( p =0.04), as compared to those without the defect. There were no significant differences in the other factors.

Subjectively severe metamorphopsia after surgery for RRD could be confirmed objectively using PHP. In the case of older patients and persistent submacular fluid, metamorphopsia would develop more frequently due to displacement of the photoreceptors in the process of reattachment.