Results of primary retinal reattachment surgery: a prospective audit

To define the current success rate of primary retinal detachment repair at one centre.

One hundred and fifty-three consecutive patients undergoing surgery for primary retinal detachments over a 6 month period were studied prospectively. Data sheets were completed immediately after surgery and at final follow-up. One hundred and twenty-seven patients completed 6 months of follow-up. Follow-up data on the remainder were obtained from the referring unit or directly from the patients by telephone. The term primary success was used to describe persisting retinal reattachment after a single operation. Multiple logistic regression was carried out to establish factors associated with failure.

One hundred and twenty-three patients (80%) had persisting retinal reattachment after a single procedure. Of the 30 patients who required further surgery, in 5 the retina remained detached at final follow-up. The final anatomical success rate was 97%. New or missed breaks were the major causes of failure of primary surgery. Failure of primary surgery was associated with the presence of highly elevated breaks (beta = 0.11, p = 0.03). No other pre-operative factors appeared to predict failure to reattach the retina.

Comparison of these results with those of a previous audit carried out at this hospital 23 years ago suggests little improvement in the success rate of primary surgery (75% vs 80%). The improvement in final retinal reattachment has been rather greater (from 88% to 97%). The major impact of recent technical advances in retinal reattachment surgery has been on the success rate of reoperations after failed primary surgery.