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C. C. Wykoff, W. E. Smiddy, H. W. Flynn, Jr., T. Mathen, S. G. Schwartz, W. Shi; Incidence and Clinical Features of Additional Surgical Procedures Performed Following Primary Repair of Macula-On Rhegmatogenous Retinal Detachments. Invest. Ophthalmol. Vis. Sci. 2010;51(13):1746.
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To evaluate the incidence and clinical features of additional ocular surgical procedures performed following primary repair in the management of macula-on rhegmatogenous retinal detachment (RD).
Clinical records were reviewed for all patients treated at Bascom Palmer Eye Institute between 1989 and 2006 by a single surgeon for primary, macula-sparing rhegmatogenous retinal detachments. Institutional review board approval was obtained.
Primary, fovea-sparing rhegmatogenous RD were diagnosed and treated by sclera buckle (SB) in 196 patients. Forty-six (23%) patients underwent additional surgery following initial RD repair. Persistent subretinal fluid requiring reoperation was present in 24 (12%) eyes. A single reoperation was successful in 16 (8%) eyes, 2 reoperations were required in 6 (3%) eyes, 4 reoperations were required in 1 (0.5%) eye, and 1 patient refused any reoperation (0.5%). Initial reoperations were managed with SB revision alone in 6 (26%) eyes, pars plana vitrectomy (PPV) alone in 16 (70%) eyes, and both SB revision and PPV in 1 (4%) eye. Additionally, 25 patients underwent surgery during follow-up for an indication other than recurrent retinal detachment, including cataract extraction (n=15), SB removal for extrusion (n=4), PPV with membrane peeling for epiretinal membrane (n=3), PPV for non-clearing vitreous hemorrhage (n=3) and trabeculectomy (n=2). Finally, 5 patients underwent RD repair for a new RD that occurred more than 6 months after the initial RD repair and was clinically determined to be independent of the first RD. No significant correlation was found between final vision and the need for reoperation or other secondary surgeries.
In the current series of fovea-sparing rhegmatogenous retinal detachments, 23% of patients underwent additional surgery during follow-up after initial RD repair, including 12% undergoing reoperation and 11% undergoing additional surgery other than reoperation.
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