Factors Associated With Single-Surgery Anatomical Success After Pars Plana Vitrectomy in Inferior Rhegmatogenous Retinal Detachment.

Abstract

To evaluate associations between retinopexy modality, surgical and anatomical factors, and single-surgery anatomical success (SSAS) after pars plana vitrectomy (PPV) for primary inferior rhegmatogenous retinal detachment (RRD). This retrospective single-center cohort included consecutive eyes undergoing PPV for primary inferior RRD with at least 3 months of follow-up. The primary outcome was SSAS, defined as absence of redetachment during follow-up and at least 2 months after silicone oil removal when applicable. Among 235 eyes, median follow-up was 8 months. SSAS was achieved in 175 eyes (74.5%), while 60 eyes (25.5%) redetached at a median of 35 days. SSAS was 83.3% with endolaser, 74.6% with combined retinopexy, and 64.6% with cryotherapy (p = 0.021). In multivariable analysis, endolaser was associated with lower odds of failure compared with cryotherapy (OR 0.21, 95% CI 0.09-0.48; p = 0.00037), while combined retinopexy was associated with intermediate odds of failure (OR 0.39, 95% CI 0.15-0.95; p = 0.043). Compared with PVR grade A, grade B (OR 5.19, 95% CI 2.30-12.37; p = 0.00011) and grade C (OR 10.60, 95% CI 4.15-28.84; p < 0.00001) were associated with higher odds of anatomical failure. A causative break at 6 o'clock was also associated with higher odds of failure (OR 4.61; p = 0.005). In PPV for inferior RRD, endolaser retinopexy was associated with significantly higher anatomical success than cryotherapy, with combined treatment yielding intermediate outcomes. No significant association was observed between anatomical outcome and tamponade choice or PFCL use.