Predictive Risk Factors for Retinal Redetachment Following Uncomplicated Pars Plana Vitrectomy for Primary Rhegmatogenous Retinal Detachment

Abstract

Purpose: To investigate clinical and surgical factors influencing the outcome after primary rhegmatogenous retinal detachment surgery. Methods: A retrospective, single-centre, case-control study of 1017 eyes of 1017 consecutive patients with primary rhegmatogenous retinal detachment (RRD) who underwent pars plana vitrectomy (PPV), were included in the study. Analysed surgical factors were: combined procedure with phacoemulsification, type of retinopexy (cryocoagulation, endolaser, combined), type of tamponade (gas, silicone oil), and anatomical factors: primary proliferative vitreoretinopathy (PVR) and macular detachment at the time of surgery. Results: Overall retinal re-detachment rate was 10.1%. The main reason for re-detachment was an insufficient retinopexy in 53.6%, followed by PVR (37.3%), and retinal detachment occurred at a different location caused by another break in 9.1%. No significant difference in the rate of re-detachment was found if a phacoemulsification with simultaneous IOL implantation was performed (p = 0.641). No significant difference between the various retinopexy techniques was found (p = 0.309). Risk factors re-detachment were primary PVR (p = 0.0003), silicone oil as initial tamponade (p = 0.0001) as well as macula off detachments (p = 0.034). Conclusions: The present study showed no significant difference between the types of retinopexy and if additional phacoemulsification was performed or not. Factors associated with a higher risk for re-detachment were detached macula at surgery, primary PVR and primary oil-filling.

Outcomes and predictors of vitrectomy and silicone oil tamponade in retinal detachments complicated by proliferative vitreoretinopathy

“…In the present study, we found that the visual outcomes were worse in eyes undergoing vitrectomy for PVR-associated retinal detachment after failed previous vitrectomy than in the eyes undergoing primary vitrectomy. This is in keeping with previous studies, indicating that the number of previous surgeries was associated with decreased visual outcome and decreased improvement in the BCVA in eyes undergoing vitrectomy for RRD [4,33] . In our current study, the visual outcome in eyes with anatomical success after the first vitrectomy operation was significantly better as was also found in the National Eye Institute (NEI) SO Studies [23,34] .…”

“…R hegmatogenous retinal detachments (RRD) are managed with a variety of methods and the success rate for primary repair is over 80% [1][2][3] . The major cause of failure in retinal detachment repair is proliferative vitreoretinopathy (PVR) [4][5] . The key factor triggering PVR development seems to be partial dedifferentiation, migration, and proliferation of retinal pigment epithelial (RPE) cells, resulting in the formation of fibrocellular membrane [5][6][7] .…”

The Characteristics of Pseudophakic Retinal Detachment and Risk Factors of Recurrence in the North of Spain

“…Thus, the recurrence rate in our series is justi ed by the large number of patients included with both inferior (31.82%) and total (13.33%) RD, since these RD locations are associated with a RD worse evolution. In addition, the presence of macular detachment at the time of surgery (macula off) is associated with increased recurrence [32] both in the literature and in our series where most patients were macula off RD.…”

Retinal surgery quality indicators for uncomplicated primary rhegmatogenous retinal detachment without a national registry

“…Our material also has a preponderance of C 2 F 6 use. Many surgeons probably choose the type of gas tamponade based on the number of breaks and their locations, but the choice is also determined by the patient's ability to position or other aspects based on the patient's preference (Sahanne et al 2017;Guber et al 2020). We believe surgeons need a special indication to select SO as a tamponade.…”