Outcomes of Recurrent Retinal Detachment Surgery following Pars Plana Vitrectomy for Rhegmatogenous Retinal Detachment

Semin Ophthalmol. 2018;33(5):657-663. doi: 10.1080/08820538.2017.1395893. Epub 2017 Nov 10.

Abstract

Aim: To study the anatomical and functional outcomes of recurrent retinal detachment (RD) surgery following pars plana vitrectomy (PPV) for rhegmatogenous retinal detachment.

Methods: Retrospective analysis of 133 consecutive cases of recurrent RD.

Inclusion criteria: age ≥18 years, recurrent RD following PPV ± encircling band for rhegmatogenous RD.

Exclusion criteria: age <18 years, post-endophthalmitis/tractional/exudative/combined RD, post-scleral buckle, primary surgery done at another institute. The final anatomical and functional outcomes, and their association with clinico-surgical factors, were analyzed.

Results: Proliferative vitreoretinopathy (PVR) ≥ Grade C in re-detached retina (OR, 2.49; 95% CI, 1.02-6.09; P = 0.045) and need for multiple resurgeries (OR, 6.48; 95% CI, 2.51-16.69; P < 0.0001) were significant risk factors for the final anatomical failure. Eyes with PVR ≥ Grade C (OR, 0.31, 95% CI, 0.12-0.80; P = 0.013) in primary RD, and with multiple breaks (OR, 0.24; 95% CI, 0.06-0.96; P = 0.044) at the time of recurrent RD, were less likely to have final BCVA ≥20/200. The visual acuity at the time of recurrent RD had a moderately positive correlation (r = 0.454, P < 0.001), and the delay in recurrence of RD had a weakly positive correlation (r = 0.214, P = 0.046) with the final BCVA.

Conclusions: PVR ≥ Grade C and multiple resurgeries are associated with higher incidence of anatomical failure in recurrent RD surgery. Multiple breaks are associated with a poorer visual outcome, whereas a better baseline visual acuity and delayed recurrence of RD after primary repair are associated with a better visual outcome.

Keywords: Anatomical success; functional outcome; recurrent retinal detachment; resurgery; risk factors.

MeSH terms

  • Endotamponade
  • Female
  • Humans
  • Male
  • Middle Aged
  • Postoperative Complications / diagnosis
  • Postoperative Complications / etiology
  • Postoperative Complications / surgery*
  • Recurrence
  • Reoperation
  • Retina / diagnostic imaging
  • Retina / metabolism*
  • Retinal Detachment / diagnosis
  • Retinal Detachment / etiology
  • Retinal Detachment / surgery*
  • Retrospective Studies
  • Risk Factors
  • Treatment Outcome
  • Visual Acuity*
  • Vitrectomy / adverse effects*