Management of recurrent rhegmatogenous retinal detachment

Abstract

Rhegmatogenous retinal detachment (RRD) repair is one of the most common vitreoretinal surgeries a surgeon performs. In an ideal scenario, RRD can be repaired with a single surgical intervention; however, despite excellent skill, flawless technique, and the introduction of high-end technology, up to 10% of cases require additional interventions to ultimately repair recurrent detachments. It is thus important to study the outcomes of multiple interventions to understand whether performing repeat vitrectomy on patients with a history of failed surgeries is worthwhile. Thus, recurrent retinal detachment (re-RD) remains a significant challenge for vitreoretinal surgeons as well as the patients considering the economic and the emotional burden of undergoing multiple interventions. The advent of microincision vitrectomy system, perfluorocarbon liquids, and effective intraocular tamponades has opened new doors for managing re-RDs. In this article, we have reviewed and summarized the various causes and approaches for management for optimal anatomical and functional outcomes.

Keywords: Perfluorocarbon liquid; proliferative vitreoretinopathy; recurrent retinal detachment; resurgery; scleral buckle; silicone oil; vitrectomy.

Figure 1

Flow chart for management of recurrent retinal detachment. RRD: Rhegmatogenous retinal detachment; re-RD: recurrent retinal detachment; SO: silicone oil; PVR: proliferative vitreoretinopathy; SB: scleral buckle; PR: pneumatic retinopexy; SOR: silicone oil removal