June 2022
Volume 63, Issue 7
Open Access
ARVO Annual Meeting Abstract  |   June 2022
Outcomes in recurrent rhegmatogenous retinal detachment repair: does initial surgery impact results?
Author Affiliations & Notes
  • Mélanie Hébert
    Ophthalmology, Hopital du Saint-Sacrement, Quebec, Quebec, Canada
  • Jerome Garneau
    Ophthalmology, Hopital du Saint-Sacrement, Quebec, Quebec, Canada
  • Eunice You
    Ophthalmology, Hopital du Saint-Sacrement, Quebec, Quebec, Canada
  • Serge Bourgault
    Ophthalmology, Hopital du Saint-Sacrement, Quebec, Quebec, Canada
  • Mathieu Caissie
    Ophthalmology, Hopital du Saint-Sacrement, Quebec, Quebec, Canada
  • Éric Tourville
    Ophthalmology, Hopital du Saint-Sacrement, Quebec, Quebec, Canada
  • Ali Dirani
    Ophthalmology, Hopital du Saint-Sacrement, Quebec, Quebec, Canada
  • Footnotes
    Commercial Relationships   Mélanie Hébert None; Jerome Garneau None; Eunice You None; Serge Bourgault None; Mathieu Caissie None; Éric Tourville None; Ali Dirani None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2022, Vol.63, 3437 – F0337. doi:
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      Mélanie Hébert, Jerome Garneau, Eunice You, Serge Bourgault, Mathieu Caissie, Éric Tourville, Ali Dirani; Outcomes in recurrent rhegmatogenous retinal detachment repair: does initial surgery impact results?. Invest. Ophthalmol. Vis. Sci. 2022;63(7):3437 – F0337.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : More studies now guide the management of primary rhegmatogenous retinal detachment (RRD), but less is known on managing recurrent RRD (re-RRD). We analyzed outcomes in re-RRD repair using pars plana vitrectomy (PPV) only or PPV with scleral buckle (PPVSB) in a retrospective cohort study.

Methods : Patients operated for re-RRD at the Centre hospitalier universitaire de Québec – Université Laval between 2014 and 2018 were included. Exclusion criteria included: non-RRD etiologies of initial detachment (e.g., traumatic, tractional), initial RRD with proliferative vitreoretinopathy (PVR) grade ≥C2, and patients with silicone oil during first surgery. Procedure choice at first and second surgery was at the surgeon’s discretion. Patients were categorized based on surgery sequence of first and second surgery: PPV then PPV (PPV-PPV), PPV then PPVSB (PPV-PPVSB), or PPVSB then PPV (PPVSB-PPV). Primary outcome was recurrent surgery success rate (re-SSR) and secondary outcome was final pinhole visual acuity (PHVA) in logarithm of the minimum angle of resolution (logMAR).

Results : There were 139 patients included. Twelve (9%) underwent PPV-PPV, 51 (37%) underwent PPV-PPVSB, and 76 (55%) underwent PPVSB-PPV. Median [Q1, Q3] age at initial presentation was 64 [59, 72] years. There were 85 (61%) men, 63 (45%) pseudophakic patients, and 24/114 (21%) high myopic patients. Baseline PHVA in logMAR was 0.88 [0.18, 2.30].
Surgery sequence did not significantly alter re-SSR (PPV-PPV: 9, 75% vs. PPV-PPVSB: 38, 75% vs. PPVSB-PPV: 57, 75%; p=1.00). It also did not change the use of silicone oil at second surgery (PPV-PPV: 5, 42% vs. PPV-PPVSB: 18, 35% vs. PPVSB-PPV: 36, 47%; p=0.40). At final follow-up, PHVA was 0.60 [0.18, 1.00] and did not significantly differ by sequence (p=0.16). In multiple regression analyses, main factors influencing re-SSR were pseudophakia (odds ratio (OR) 3.356, p=0.012) and initial macula-off status (OR 0.368, p=0.048), while surgery sequence did not alter re-SSR (p>0.05).

Conclusions : Following re-RRD repair, there were no significant differences in re-SSR and final PHVA based on sequence of surgery. Pseudophakia increased re-SSR, and macula-off status decreased re-SSR. This is likely because pseudophakia allows a closer shave of the vitreous base to reduce the incidence of postoperative PVR and recurrent tears, while macula-off status suggests a more extensive initial detachment.

This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.

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