Clinical Features and Outcomes of Late Recurrent Rhegmatogenous Retinal Detachment

To evaluate clinical features and outcomes in patients with late recurrent primary non-complex rhegmatogenous retinal detachment (LRRD).

A retrospective review was conducted for LRRD cases, defined as redetachment occurring ≥3 months after complete primary reattachment, excluding eyes with silicone oil tamponade at initial surgery.

Among 1,879 eyes undergoing primary retinal detachment surgery, 69 eyes (4%) experienced LRRD. Mean age was 59.6 ± 15.8 years, with 58% male. Initial surgeries included scleral buckle (SB) alone (22%), pars plana vitrectomy (PPV) alone (29%), and combined SB/PPV (49%). Recurrence occurred at a mean of 7.9 ± 9.1 months. The mean interval between initial retinal detachment surgery and LRRD was 7.9 ± 9.1 months, with a median of 4.9 months (range: 3 months to 4 years).At recurrence, 45% of eyes were phakic, 55% pseudophakic, and 45% had proliferative vitreoretinopathy (PVR) grade C or higher. Macula involvement was observed in 54%, and new or undiagnosed breaks in 64%. Surgical repair included PPV alone (74%) and combined SB/PPV (26%), with silicone oil used in 75%. Reattachment was achieved in 93%. At the final follow-up, silicone oil tamponade remained in 5 eyes (7%) and BCVA was ≥20/40 in 16%, 20/40-20/200 in 38%, and ≤20/200 in 46%. A comparative analysis of LRRDs after 3 or 6 months showed no significant differences in surgical traits or final reattachment rates.

Late recurrence of retinal detachment presents considerable management challenges and often has guarded visual outcomes despite successful anatomic reattachment.