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  • Patient’s age tied to reoperation risk after retinal detachment repair

    Retina/Vitreous

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    Review of: Reoperation rates of patients undergoing primary noncomplex retinal detachment surgery in a cohort of the IRIS Registry

    Rao P, Kaiser R, Lum F, et al. American Journal of Ophthalmology, in press

    This IRIS Registry study evaluated reoperation rates of patients who underwent a primary noncomplex retinal detachment (RD) repair between 2013 and 2016.

    Study design

    Using the IRIS Registry database, researchers identified 24,068 patients who underwent RD repair with either a scleral buckle (SB) or pars plana vitrectomy (PPV) with or without SB. The primary outcome was the odds of reoperation within 12 months.

    Outcomes

    In this cohort, 2,937 patients (12%) underwent a SB and 21,131 patients (88%) underwent PPV. The overall reoperation rate was 12.2% for SB and 11.6% for PPV. Patients aged 50 years or younger who underwent PPV, with or without SB, had higher odds of reoperation (OR 1.46) compared with those who underwent SB only. Patients aged more than 50 years old undergoing PPV had lower odds of reoperation (OR 0.73).

    Limitations

    Due to the nature of billing coding data used in studies analyzing the IRIS database, PPV with SB and PPV without SB cannot be separately analyzed. This limits the ability to ascertain if the differences between procedures is influenced by SB placement.

    Clinical significance

    Both SB and PPV with or without SB are effective for treating retinal detachment and lead to redetachment rates around 12%. Patients 50 years or younger appear to have lower redetachment rates with SB compared with PPV with or without SB. The role of PPV combined with SB needs to be further studied.