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  • Visual acuity decreases with each additional rhegmatogenous retinal detachment repair

    Retina/Vitreous

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    Review of: Outcomes of Eyes Undergoing Multiple Surgical Interventions after Failure of Primary Rhegmatogenous Retinal Detachment Repair

    Stenz E, Yu H, Shah A, et al. Ophthalmology Retina, May 2022

    Anatomic success rates and habitual best-recorded visual acuity (VA) after at least 2 rhegmatogenous retinal detachment repairs were examined to provide more information on the likelihood of future surgical success, which can be used to decide about undergoing additional procedures.

    Study design

    This retrospective, consecutive case series looked at trends in eyes that underwent greater than or equal to 2 rhegmatogenous retinal detachment repairs.

    Outcomes

    Although primary detachment repair was high (92.4%), primary repair failed in 166 (7.6%) eyes out of 2187 total eyes. Even in subsequent surgeries, the probability of anatomic success remained relatively constant. Eyes having proliferative vitreoretinopathy (PVR) at the time of the third surgery were more likely to require additional surgery, and eyes using silicone oil endotamponade during the second surgery were less likely to require a third surgery. Final visual acuity decreased with each subsequent surgery.

    Limitations

    This study had limitations due to its retrospective nature using clinic charts for data collection. There were gaps in data including epiretinal membrane and posterior vitreous detachment statuses at the time of surgery, and consistent VA measurements. ETDRS charts were not consistently used, and so there may be some variability in VA measurements. The study also does not control for type of surgery used (pars plana vitrectomy (PPV), combination PPV with scleral buckle (SB), or SB alone), which could affect the success rates.

    Clinical significance

    This study shows that although the overall anatomic success rate was 95.8%, there are certain characteristics that may impact subsequent surgeries, including PVR presence and endotamponade choice.