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Michael McClintock, Kourous Rezaei; Characteristics of Eyes with Rhegmatogenous Retinal Detachment Requiring Multiple Rettachment Surgeries. Invest. Ophthalmol. Vis. Sci. 2014;55(13):1088.
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© ARVO (1962-2015); The Authors (2016-present)
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.
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.
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.
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%).
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