Outcomes of Recurrent Retinal Detachment Surgery following Pars Plana Vitrectomy for Rhegmatogenous Retinal Detachment
Ambiya, V.; Rani, P.Kumari.; Narayanan, R.; Balakrishnan, D.; Chhablani, J.; Jalali, S.; Tyagi, M.; Pappuru, R.Reddy.
Seminars in Ophthalmology 33(5): 657-663
To study the anatomical and functional outcomes of recurrent retinal detachment (RD) surgery following pars plana vitrectomy (PPV) for rhegmatogenous retinal detachment. Retrospective analysis of 133 consecutive cases of recurrent RD. age ≥18 years, recurrent RD following PPV ± encircling band for rhegmatogenous RD. 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. Proliferative vitreoretinopathy (PVR) ≥ Grade C in re-detached retina (OR, 2.49; 95% CI, 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. 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.