Surgeon Volume and Success Rate in Primary Rhegmatogenous Retinal Detachment

Area of Science:

• Ophthalmology
• Retinal Surgery

Background:

• Rhegmatogenous retinal detachment (RD) is a serious ocular condition requiring surgical intervention.
• Understanding factors influencing the success of primary RD repair is crucial for improving patient outcomes.

Purpose of the Study:

• To determine the incidence of revision surgery after primary rhegmatogenous retinal detachment (RD) repair.
• To identify predictors of RD revision in Medicare beneficiaries.

Main Methods:

• Retrospective analysis of adult patients undergoing RD repair (scleral buckle and/or vitrectomy) within the Medicare dataset.
• Data included patient demographics, RD characteristics (ICD-10 modifiers), and surgical procedures (CPT codes).
• Surgeon factors analyzed included volume, graduation year, and practice setting; RD revision was defined as repeat surgery within 2 years.

Main Results:

• A total of 25,456 surgeries were analyzed; 14.3% required revision.
• The median time to revision was 73 days.
• Significant predictors for RD revision included greater retinal thickness (GRT), total RD, and complex vitrectomy +/- buckle.

Conclusions:

• The incidence of RD revision was 14.3% among Medicare beneficiaries.
• Complex vitrectomy, GRT, and total RD are associated with an increased risk of revision.
• Surgeon and practice volumes were not found to be significant predictors of RD revision.