Abstract
Purpose:
To review characteristics of eyes with rhegmatogenous retinal detachment that underwent pars plana vitrectomy, scleral buckle, or both in combination that required multiple surgeries to achieve retinal reattachment in a multioffice retina practice. Characteristics associated with redetachment following primary surgical repair were examined.
Methods:
A retrospective record review was conducted identifying eyes that required multiple surgeries for retinal detachment including pars plana vitrectomy (PPV), scleral buckling (SB), or a combination from January 2007 to March of 2013. Eyes with any history of previous retinal surgery were excluded.
Results:
150 charts were reviewed. 27 eyes in 27 patients were included. Mean age at the first retinal detachment was 51.8 years old (range 15 -83). 51.9% (14/27 eyes) were female. 70.4% (20/27 eyes) were phakic and 29.6% (8/27 eyes) were pseudophakic. Lattice degeneration was present in 33.3% (9 /27 eyes). Original detachment extent was 6.6 +/- 3.9 clock hours with 1.7 ± 1.0 breaks. Initial detachment breaks were confined to the superior hemiretina in 44.4% (12/27 eyes) and the inferior hemiretina in 37.0% (10/27 eyes). PVR was noted in 29.6% (8/27 eyes). Initial surgical repair was vitrectomy in 48.1% (13/27 eyes), scleral buckle in 14.8% (4/27 eyes), and combination of both in 37.0% (10/27 eyes) Average time to redetachment was 127 ± 336 days (median 48 days, range 13-1779 days). All but one eye redetached within the first year. Redetchments averaged 2.3±1.1 breaks with an extent of 8.4±3.8 clock hours and PVR was noted in 81.5% (22/27 eyes). Break location in redetachments was confined to the superior hemiretina in 18.5% and to the inferior hemiretina in 70.4%. Redetachment repair was with vitrectomy in 100% and a scleral buckle was added in 7 of 13 (53.8%) of eyes without one previously. 25.9% (7/27 eyes) required a third surgery and ultimately 2 eyes (7.4%) were considered anatomical failures.
Conclusions:
Patients requiring multiple surgeries for retinal detachment had recurrence of retinal detachment within the first year following initial retinal detachment surgery. On initial presentation these patients were predominantly phakic (70.4%) with breaks located in the superior 6 clock hours of retina (44.4%). Redetachments were more associated with breaks isolated to the inferior 6 clock hours of retina (70.4%) and PVR (81.5%).
Keywords: 697 retinal detachment