Recurrent Retinal Detachment After Pars Plana Vitrectomy For Rhegmatogenous Retinal Detachment

Abstract Background The recurrence of retinal detachment (RD) following rhegmatogenous retinal detachment (RRD) is a relatively common complication that threatens vision and requires further surgery. The purpose of this study was to investigate the risk factors and visual outcomes of recurrent RD following pars plana vitrectomy (PPV) for primary RRD. Methods This was a retrospective follow-up of 343 eyes that underwent initial PPV surgery for primary RRD. Patients were divided into a recurrence group and a reattachment group. The main outcome measures included causative factors, visual outcomes related to the recurrence of RD, and the perioperative factors most affecting the recurrence of RD. Results After retinal reattachment, we observed RD recurrence after PPV for primary RRD in 42 out of 343 eyes (12.2%) during the follow-up period. Most causes of recurrence (69%) occurred within 6 months of surgery. Univariate analysis showed that the presence of proliferative vitreoretinopathy (PVR) ≥ Grade C was significantly associated with recurrent RD (P = 0.003). Logistic regression analysis further showed that a PVR ≥ Grade C (odds ratio [OR]: 9.421; 95% confidence interval [CI]: 2.432 - 56.39; P = 0.020) was a significant predictor for the development of recurrent RD. Compared with the reattachment group, the recurrence group exhibited a significant decline in best-corrected visual acuity (BCVA) at the last follow-up visit (P = 0.000). Eyes with PVR prior to primary surgery, or at the diagnosis of re-detachment, showed a worse final BCVA. Conclusions Our analysis shows that the predominant risk factor for the recurrence of RD is a PVR ≥ Grade C. PVR prior to primary surgery, or at the diagnosis of re-detachment, was also shown to limit the recovery of final visual acuity.