Early Retinal Detachments Following Open Globe Repair: Incidence and Risk Factors

Risk factors for the development of rhegmatogenous retinal detachments (RRDs) in the early postoperative period following open globe repair (OGR) are not well understood. RRDs are often diagnosed late after OGIs, which can negatively impact visual prognosis. We assessed the incidence and risk factors that predict the development of this complication.

We conducted a retrospective case-control study of all OGIs at a single ocular trauma center from January 2016 to September 2021 where at baseline the retina was attached. Cases were defined as postoperative RRDs that developed within 90 days of OGR.

Of 96 eyes included, 40 (41.7%) subsequently developed RRD. Univariate analysis revealed initial visual acuity (VA) of light perception (LP) or worse (OR 7.64; 95% CI, 3.03-19.22; p < .01), zone 3 injuries (OR 7.54; 95% CI, 2.64-21.54; p < .01), no view of the lens (OR 4.26; 95% CI, 1.77-10.26; p < .01), and the presence of injuries external to the globe (OR 5.33; 95% CI, 2.09-13.63; p < .01) to be associated with early RRD development. On multivariate analysis, presenting VA of LP (p < .001), the presence of external injuries (p = .001), and zone 3 injuries (p = .037) remained significant. Of the 40 patients with early RD, 34 (85%) remained attached following repair, with variable visual outcomes.

Presenting VA of LP, zone 3 injuries, and external injuries to the globe confer increased risk of early postoperative RRD after OGR. The majority of RRDs can be successfully repaired.