EARLY RETINAL DETACHMENTS AFTER OPEN GLOBE REPAIR: Incidence and Risk Factors

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

The authors conducted a retrospective case-control study of all open globe injuries 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 open globe repair.

Of 96 eyes included, 40 (41.7%) subsequently developed RRD. Univariate analysis revealed initial visual acuity of light perception or worse (odds ratio 7.64; 95% CI, 3.03-19.22; P < 0.01), Zone 3 injuries (odds ratio 7.54; 95% CI, 2.64-21.54; P < 0.01), no view of the lens (odds ratio 4.26; 95% CI, 1.77-10.26; P < 0.01), and the presence of injuries external to the globe (odds ratio 5.33; 95% CI, 2.09-13.63; P < 0.01) to be associated with early RRD development. On multivariate analysis, presenting visual acuity of light perception ( P < 0.001), the presence of external injuries ( P = 0.001), and Zone 3 injuries ( P = 0.037) remained significant. Of the 40 patients with early retinal detachment, 34 (85%) remained attached after repair, with variable visual outcomes.

Presenting visual acuity of light perception, Zone 3 injuries, and external injuries to the globe confer increased risk of early postoperative RRD after open globe repair. The majority of RRDs can be successfully repaired.