CLINICAL FEATURES and OUTCOMES of LATE RECURRENT RHEGMATOGENOUS RETINAL DETACHMENT

Abstract

Purpose: To evaluate clinical features and outcomes in patients with late recurrent primary noncomplex rhegmatogenous retinal detachment (LRRD). Method: 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. Results: 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 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 five eyes (7%) and best-corrected visual acuity 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. Conclusion: Late recurrence of retinal detachment presents considerable management challenges and often has guarded visual outcomes despite successful anatomic reattachment.