Recurrent retinal detachment more than 1 year after reattachment

Area of Science:

• Ophthalmology
• Retinal Surgery
• Vitreoretinal Diseases

Background:

• Recurrent retinal detachment (RD) after initial successful reattachment is uncommon.
• Limited data exists on late recurrent RD occurring one or more years post-reattachment.
• Proliferative vitreoretinopathy (PVR) is a known complication, but its role in late recurrence is unclear.

Purpose of the Study:

• To investigate late recurrent retinal detachments (RDs) occurring at least one year after complete retinal reattachment.
• To evaluate the association of these late recurrent RDs with the classification of proliferative vitreoretinopathy (PVR).

Main Methods:

• Retrospective analysis of clinical and surgical records from a single surgeon over a 9-year period.
• Identified 10 eyes (2.2%) in nine patients with late recurrent RD after initial rhegmatogenous RD repair.
• Excluded cases with proliferative diabetic retinopathy, uveitis, or penetrating trauma.

Main Results:

• Late recurrent RD occurred 12-126 months (average 46.8 months) post-surgery.
• Causes included new breaks (5 eyes), reopened breaks (3 eyes), or both (2 eyes).
• 13 open breaks were noted, with 9 anterior to the scleral buckle. 8 eyes had Grade C PVR.

Conclusions:

• Vitreous base traction appears to be a significant factor in late recurrent RD.
• PVR was likely a secondary phenomenon, not the primary cause in most late recurrence cases.
• Surgical reoperation for late recurrent RD successfully reattached the retina and improved visual acuity in the majority of cases.