|This study found that the most common cause of late recurrence retinal detachment was anterior retinal breaks. Photo: Mark Dunbar, OD. Click image to enlarge.|
A retrospective, observational case-series showed that while late recurrence of rhegmatogenous retinal detachment (RRD) is rare, visual outcomes among these patients are typically poor and require a number of reoperations.
During the 10-year study period, researchers identified 16,396 patients diagnosed with primary RRD that was repaired with a single vitrectomy procedure. Of these, 39 eyes of 39 patients had late recurrence retinal detachment.
Based on this, the study authors reported an incidence rate of 23.8 per 10,000 cases. The average age at recurrence was 60 years, 27 patients (69%) were male and 12 (31%) female. The mean of time between the first RRD surgery and late redetachment was 122.7 weeks (859 days).
Data showed that, at primary RRD presentations, all patients had posterior vitreous detachment (PVD) and 54 percent of detachments were macula involving (54%) with multiples breaks (62%). The investigators found that the most common cause of late recurrence retinal detachment was anterior retinal breaks.
Following late recurrence of RRD, 25 of 39 eyes had full retinal re-attachment with one surgery—an overall success rate of 64 percent. Researchers reported that the main cause of surgical failure after late recurrence was as proliferative vitreoretinopathy (PVR).
An additional 76 operations were performed included reoperations, phacoemulsification and IOL. At final follow-up, the study authors reported that all 39 eyes had fully attached retinas, three of which were attached under silicone oil.
When comparing BCVA after primary detachment repair and the final BCVA following repair of the late recurrence, the study authors observed a statistically worse outcome following late recurrence.
“This is the first series to describe the incidence, clinical features, anatomical and visual outcomes of the late recurrence of retinal detachment which has been successfully repaired by a single vitrectomy and gas,” the study authors noted in their recent Retina paper. “Late recurrence of retinal detachment is a rare entity which is characterized by small anterior breaks and a significant percentage of breaks that are difficult to localize.”
Although reattachment can be achieved in most patients, “a high number of reoperations are required with subsequently poor visual outcomes,” they concluded.
Anguita R, Makuloluwa A, Sim SY, et al. Late Recurrence of Retinal Detachment: Incidence, Clinical Features and Surgical Outcomes. Retina. August 30, 2023 [Epub ahead of print].