Delayed-Onset Recurrent Retinal Detachment More Than One Year After Pneumatic Retinopexy, Scleral Buckle, or Vitrectomy for Primary Rhegmatogenous Retinal Detachment Repair: Incidence, Characteristics, and Outcomes.

Abstract

To evaluate the incidence, causes, and outcomes of recurrent rhegmatogenous retinal detachment (RRD) occurring more than 12 months after the initial RRD repair. This retrospective case series examined patients who underwent primary pneumatic retinopexy (PnR), scleral buckle (SB), pars plana vitrectomy (PPV), or combined PPV/SB for primary RRD and were followed for at least 12 months. Patients treated with silicone oil were excluded. The primary outcome was the incidence of delayed recurrent RRD. Of 3668 eyes included, 293, 545, 1839, and 991 eyes underwent PnR, SB, PPV, and PPV/SB, respectively, as the initial RRD repair. The mean follow-up length was 4.9 ± 2.6 (range, 1-11.9) years. Fifty-one eyes (1.4%) from 51 patients developed delayed re-detachment. The time to delayed re-detachment was 3.8 ± 3.0 years. The incidence was 4.4% after PnR, 2.8% after SB, 0.9% after PPV, and 0.6% after PPV/SB. The incidence was greatest after PnR and lowest after PPV/SB (P < 0.001). The causes of re-detachment included new tears (31 eyes [60.8%], of which 11 had new tears adjacent to the laser retinopexy used to treat the original break), proliferative vitreoretinopathy (11 eyes [21.6%]), and other (9 eyes [17.6%]). Reoperation resulted in anatomic success of 88.2% at 3 months and 98.9% at the final visit. Recurrence of RRD more than 12 months after initial surgery may occur in 1.4% of patients, with a higher incidence after PnR and a lower incidence after PPV and PPV/SB. Reoperation resulted in acceptable anatomic outcomes.