Characteristics of rhegmatogenous retinal detachments secondary to retinal dialyses

The pattern of retinal features in patients with retinal detachment caused by retinal dialyses is poorly described. The association with trauma has also been inconsistently reported. The authors aim to analyze patient and retinal characteristics in such cases and identify the proportion where trauma is likely causative mechanism.

Retrospective case series.

Sixty-three eyes from 63 patients with retinal detachment secondary to retinal dialysis.

Population was selected from consecutive patients presenting to a single surgeon at a tertiary referral vitreoretinal service (2001-2010).

Sixty-three patients were identified (4.4% incidence rate). The cohort had a mean age of 32 years with a male preponderance (67%). Seventy-one percent had a single break, 21% had 2 breaks, and 8% had 3 to 7 breaks. Six percent of eyes had dialyses smaller than 0.5 disc diameters. Eighty-one percent of eyes had inferotemporal dialyses, but other quadrants also were involved in 25%, or exclusively in 17.5%. The primary success rate for surgery was 92% (94% final success). The presence of proliferative vitreoretinopathy (PVR) was rare (4 cases) but was a significant factor in failure of retinal reattachment (p < 0.001). Twenty-two percent were regarded as traumatic (93% male; p < 0.05). Other variables were similar between traumatic and nontraumatic eyes.

Most retinal dialyses are located inferotemporally; however, multiple dialyses, small dialyses, and dialyses that involve multiple quadrants may be seen. In patients with evidence of direct globe injury, no difference in the pattern of retinal presentation of the dialyses was observed. Although surgical success rates are high, patients with PVR had poor response to surgery.