Outcomes of Recurrent Retinal Detachment Surgery following Pars Plana Vitrectomy for Rhegmatogenous Retinal Detachment

摘要

Aim: To study the anatomical and functional outcomes of recurrent retinal detachment (RD) surgery following pars plana vitrectomy (PPV) for rhegmatogenous retinal detachment. Methods: Retrospective analysis of 133 consecutive cases of recurrent RD. Inclusion criteria: age = 18 years, recurrent RD following PPV +/- encircling band for rhegmatogenous RD. Exclusion criteria: age 18 years, post-endophthalmitis/tractional/exudative/combined RD, post-scleral buckle, primary surgery done at another institute. The final anatomical and functional outcomes, and their association with clinico-surgical factors, were analyzed. Results: Proliferative vitreoretinopathy (PVR) = Grade C in re-detached retina (OR, 2.49; 95% Cl, 1.02-6.09; P = 0.045) and need for multiple resurgeries (OR, 6.48; 95% CI, 2.51-16.69; P 0.0001) were significant risk factors for the final anatomical failure. Eyes with PVR = Grade C (OR, 0.31, 95% CI, 0.12-0.80; P = 0.013) in primary RD, and with multiple breaks (OR, 0.24; 95% CI, 0.06-0.96; P = 0.044) at the time of recurrent RD, were less likely to have final BCVA = 20/200. The visual acuity at the time of recurrent RD had a moderately positive correlation (r = 0.454, P 0.001), and the delay in recurrence of RD had a weakly positive correlation (r = 0.214, P = 0.046) with the final BCVA. Conclusions: PVR = Grade C and multiple resurgeries are associated with higher incidence of anatomical failure in recurrent RD surgery. Multiple breaks are associated with a poorer visual outcome, whereas a better baseline visual acuity and delayed recurrence of RD after primary repair are associated with a better visual outcome.