Recurrent Rhegmatogenous Retinal Detachment: Characteristics, Risk Factors, and Outcomes

Abstract

Purpose: Rhegmatogenous retinal detachment (RRD) is a severe retinal disorder that can lead to vision impairment and potentially blindness. After RRD repair surgery, every vitreoretinal surgeon aims to understand the characteristics of the RRD and to achieve permanent flattening without any recurrence. This study aimed to identify factors predisposing patients to recurrent RRD.

Patients and methods: This retrospective study was conducted at King Abdullah University Hospital and included all patients who underwent pars plana vitrectomy for RRD repair between January 2015 and December 2023. All demographic, clinical, operative, and outcome data were extracted. The primary outcome was to assess the risk factors affecting the recurrence of RRD. The secondary outcome included factors affecting the final status (flat or detached) of the retina. Using proper statistical methods, the results were generated.

Results: The study comprised 348 patients with primary RRD, of whom 44.5% had a previous ocular surgical history. The rate of recurrent RRD was 28.2%. At the last follow-up, 12.6% of the whole patients had persistent retinal detachment without anatomical successful reattachment. Superior-based RRD was the most common type, affecting 145 of 290 patients, and macular involvement in the RRD was observed in 80% of the cases. Recurrent RRD was higher in younger ages, longer duration of symptoms, extensive total type of RRD, involvement of inferior quadrants, detached macula, presence of proliferative vitreoretinopathy, and insufficient prophylactic laser retinopexy (p < 0.05). On multivariate logistic analysis, extensive total RRD, presentation duration, and insufficient prophylactic laser retinopexy were considered as a significant independent factor.

Conclusion: Duration of symptoms, involvement of more quadrants, and insufficient laser retinopexy could influence RRD recurrence. These results may coincide with previous literature but provide insights into the newly investigated population. Increasing the awareness of RRD symptoms, identifying high-risk patients, and ensuring prompt surgical intervention may reduce RRD-related complications and decrease the rate of recurrence.

Keywords: pars plana vitrectomy; proliferative vitreoretinopathy; prophylactic retinopexy; recurrent retinal detachment; retinal tamponade; rhegmatogenous retinal detachment.

Figure 1

Chart for the characteristics of recurrent RRD cases.