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Clinical science
Recurrent retinal detachment: does initial treatment matter?
  1. A Mansouri1,
  2. A Almony1,2,
  3. G K Shah1,2,
  4. K J Blinder1,2,
  5. S Sharma3
  1. 1Department of Ophthalmology and Visual Sciences, Washington University School of Medicine, St Louis, Missouri, USA
  2. 2Barnes Retina Institute, Washington University School of Medicine, St Louis, Missouri, USA
  3. 3Departments of Ophthalmology and Epidemiology, Queen's University, Kingston, Ontario, Canada
  1. Correspondence to Gaurav K Shah, Barnes Retina Institute and Department of Ophthalmology and Visual Sciences, Washington University, Suite 800, 1600 South Brentwood Boulevard, St Louis, MO 63144, USA; gkshah1{at}gmail.com

Abstract

Background/Aims To evaluate the treatment course of patients with primary rhegmatogenous retinal detachment (RRD) that re-detach after initial retinal detachment surgery.

Methods Patients were divided into three groups based on initial surgical treatment: scleral buckle procedure (SBP) (63 eyes), pars plana vitrectomy (PPV) (88 eyes) and combined SBP/PPV (135 eyes). Charts were reviewed for a mean follow-up of 12 months.

Results Average number of secondary procedures to achieve anatomical success was lowest in the SBP group (1.1), compared with the PPV group (1.47) and the SBP/PPV group (1.5) (p<0.05). Patients that re-detached after initial PPV/SBP, PPV or SBP required silicone oil injection in 83%, 60% and 22% of the cases and had final best-corrected visual acuity better than or equal to 20/50 in 21%, 33% and 45% of the cases, respectively. Phakic patients that re-detached after initial treatment with PPV/SBP, PPV and SBP required pars plana lensectomy (PPL) in 42%, 25% and 12.5% of the cases, respectively.

Conclusion Patients with primary RRD that re-detach after initial treatment with SBP require fewer number of secondary operations and silicone oil injections, show a trend for better visual outcomes and are less likely to develop dense cataract or to require PPL compared to patients that re-detach after initial PPV or PPV/SBP.

  • Retinal detachment
  • pars plana vitrectomy
  • scleral buckling surgery
  • retina
  • treatment surgery

http://dx.doi.org/10.1136/bjo.2009.175968

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    Footnotes

    • Competing interests None.

    • Ethics approval This study was conducted with the approval of the institutional review board of Barnes Jewish Hospital and Washington University, St Louis, Missouri, USA.

    • Provenance and peer review Not commissioned; externally peer reviewed.