Recurrent rhegmatogenous retinal detachment: incidence, established and emerging risk factors, and clinical outcomes

Recurrent rhegmatogenous retinal detachment (RRD) remains a significant cause of visual morbidity despite advances in surgical techniques, and its determinants and clinical course are not yet fully defined. This study aimed to evaluate the incidence, risk factors, and outcomes of recurrent RRD in a large cohort at an Italian tertiary referral center.

This retrospective study included patients with primary RRD who underwent pars plana vitrectomy, scleral buckling, or both. Associations between clinical and intraoperative variables and recurrent RRD were analysed using multivariable logistic regression.

A total of 209 eyes from 209 patients were included. The overall recurrence rate was 21.1%, with 52.3% of recurrences occurring within the first six postoperative weeks. Multivariate logistic regression identified proliferative vitreoretinopathy (PVR grade B or higher) (OR = 4.68, p = 0.006), high myopia (OR = 4.25, p = 0.002), preoperative glaucoma (OR = 4.08, p = 0.014), and systemic hypertension (OR = 2.72, p = 0.031) as independent predictors of recurrence. Final best-corrected visual acuity was significantly worse in eyes with recurrence (p < 0.001). Eyes with recurrent retinal detachment showed a significantly higher prevalence of cystoid macular edema.

This study confirms PVR and high myopia as risk factors for recurrent RRD and suggests preoperative glaucoma and systemic hypertension as additional predictors of recurrence. These findings highlight the importance of risk stratification in guiding individualized surgical planning, intensified early postoperative surveillance, and long-term follow-up to reduce recurrence and preserve visual outcomes.