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  • Title: Outcomes of Recurrent Retinal Detachment Surgery following Pars Plana Vitrectomy for Rhegmatogenous Retinal Detachment.
    Author: Ambiya V, Rani PK, Narayanan R, Balakrishnan D, Chhablani J, Jalali S, Tyagi M, Pappuru RR.
    Journal: Semin Ophthalmol; 2018; 33(5):657-663. PubMed ID: 29125779.
    Abstract:
    AIM: To study the anatomical and functional outcomes of recurrent retinal detachment (RD) surgery following pars plana vitrectomy (PPV) for rhegmatogenous retinal detachment. METHODS: Retrospective analysis of 133 consecutive cases of recurrent RD. INCLUSION CRITERIA: age ≥18 years, recurrent RD following PPV ± encircling band for rhegmatogenous RD. EXCLUSION CRITERIA: 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. RESULTS: 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. CONCLUSIONS: 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.
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