Rhegmatogenous Retinal Detachment Surgery Patients Frequently Undergo Additional Procedures

Nearly a quarter of patients returned to the operating room within 6 months of undergoing rhegmatogenous retinal detachment (RRD) repair, according to results of a study published in Clinical Ophthalmology.

Eyes (N=1278) that underwent RRD repair at the Bascom Palmer Eye Institute in the United States between 2014 and 2016 were evaluated for return to surgery at any time after initial repair. Cases (n=507) and controls (n=771) were evaluated for potential risks for requiring repeat surgery.

Patients were aged mean 56.4 (range, 7.75-98.8) years, 67% were boys or men, and the most common procedure was combined scleral buckle (SB) with pars plana vitrectomy (PPV; 61.2%) followed by PPV (20.7%), and SB (17.6%).

During the primary procedure, 64.1% of eyes were phakic, 34.7% were pseudophakic, and 1.3% were aphakic.

More than a third of eyes (39.7%) underwent reoperation by the final follow-up (mean, 1.3 years), by 6 months, 24.9% required reoperation and by 1 year, 34.7%. No differences in gender (P =.37) or age (P =.83) were observed between cases and controls.

In total, 27.3% of eyes had 1 additional surgery, 7.9% 2 additional procedures, and 4.4% 3 or more.

The most common indications for reoperation were cataract (43.9%), recurrent RRD (12.8%), retained silicone oil (10.6%), and proliferative vitreoretinopathy (5.0%). The most common repeat procedure was membrane peel for epiretinal membrane (n=49).

Return to the operating room was more likely among eyes that underwent SB/PPV in their initial operation (χ², 35.83; P <.001) with an increased rate of undergoing cataract surgery in a subsequent operation (χ², 59.9; P <.001). Returning for RRD revision was more likely among eyes that underwent an initial SB/PPV procedure (χ², 9.92; P =.007).

These findings may be biased as data were collected at a tertiary care center and this study population had a high rate of comorbidities and history of trauma.

This study found that over a third of eyes that underwent RRD repair returned to the operating room, nearly a quarter returning within 6 months. Most eyes required 1 reoperation for cataract or recurrent RRD.

Reference

Staropoli PC, Brown K, Townsend JH. Return to the operating room after repair of rhegmatogenous retinal detachment. Clin Ophthal. 2022;16(5):1391-1399. doi:10.2147/OPTH.S360313