Surgical treatment remains the mainstay for rhegmatogenous retinal detachment (RRD), but surgical procedures are complex and accompanied by a higher risk of choroidal detachment due to the high incidence of postoperative proliferative vitreoretinopathy. Researchers in China recently conducted a retrospective analysis investigating the clinical characteristics of RRD with choroidal detachment. They determined male sex, middle age, scleral buckling and longer axial length (AL) to be risk factors for recurrent retinal detachment.
The retrospective study reviewed 1,212 patients with RRD with choroidal detachment. The average age of the patients was 48.51 years, and 62.7% were male. Among the cohort, 85.5% underwent pars plana vitrectomy (PPV) with either silicone oil (82.8%) or gas (2.6%), 11.9% underwent scleral buckling and 2.6% underwent PPV (silicone oil) combined with an encircling band procedure.
The researchers found that scleral buckle surgery was the preferred operation at the beginning of the study period, but PPV gained more attention later. For scleral buckle participants, 74.62% had recurrent retinal redetachment within three months after the first operation, 84.3% within six months and 92.3% within 12 months.
Myopia was accounted for in 92.6% of patients, with 69.0% having high myopia (AL>26mm). The incidence of recurrence increased with AL, the study noted. While the proportion of aphakic eyes was higher in the recurrent group than in the non-recurrent group, the difference was not statistically significant.
“The differences in the anatomy of the eye and vitreous between males and females may explain the increased risk of recurrent retinal detachment in males,” the researchers proposed in their paper.
Jia LY, Sun YX, Zhang YP, et al. Risk Factors of recurrent retinal detachment following surgical treatment for rhegmatogenous retinal detachment: a retrospective study. Risk Manag Healthc Policy. 2020;13:3165-71.