Abstract
Purpose :
Failure of primary rhegmatogenous retinal detachment (RRD) repair is an unwanted clinical outcome associated with decreased final visual outcomes compared to successful primary RRD repair. The current study characterized surgical approaches and rates of recurrent RRD (re-RRD) repair.
Methods :
Data was retrospectively collected from electronic heath records from a large, urban retina practice with 14 physicians. Inclusion criteria were failed primary RRD repair with ≥2 RRD repairs from 2016 through 2020. Exclusion criteria were non-rhegmatogenous etiologies of RD, previous vitreoretinal surgery in the study eye, and proliferative diabetic retinopathy. Analyzed parameters included epidemiological data, surgical information, and post-operative outcomes. Statistical analysis was performed using Pearson’s chi-squared test and one-way ANOVA analysis with Tukey’s HSD to assess the relationship of surgical procedure with re-RRD rates and recurrence time. Statistical significance was defined as P<0.05.
Results :
195 among 2,187 eyes undergoing primary RRD repair developed re-RRD (8.9%). Among this population, the mean number of RRD repairs performed was 2.4 ± 0.7 (range 2-5). During initial RRD repair, 9.2% of eyes received an encircling scleral buckle (SB) without pars plana vitrectomy (PPV) while 90.8% of eyes underwent PPV ± SB. The likelihood of repair success following the second RRD repair was 72.3% while 27.7% of eyes required ≥3 RRD surgeries (Table 1), and the risk of subsequent RRD repair with respect to the number of pre-existing RRD repairs is summarized in Table 2. Eyes undergoing one RRD repair were less likely to undergo further procedures (8.9%) than eyes undergoing ≥2 RRD repairs; after the second RRD repair, the risk for further RRD repairs appeared to remain constant (20.4-27.7%) (Table 2). Moreover, repair of the presenting RRD with an encircling SB alone was associated with a lower rate of need for additional repairs than initial repair by PPV ± SB (P<0.05).
Conclusions :
This study, limited by its retrospective design and inherent biases, describes the rates of re-RRD repair among all patients presenting with RRD. An association was observed between the primary surgery type and need for re-RRD repair which may be valuable for patient counseling. Additional work regarding risk factors for undergoing re-RRD repair may allow for mitigating strategies to be considered.
This is a 2021 ARVO Annual Meeting abstract.