Claire Douat, Frank Becquet, Didier Ducournau, Nantes, France

Purpose:

Retinal reattachment can be achieved by different surgical approaches such as primary posterior vitrectomy (PPV) or scleral buckling techniques (SB). Recently, PPV as a first intention treatment for rhegmatogenous retinal detachment (RRD) has become fashionable in comparison with SB. The aim of this retrospective study was to evaluate the risk factors for RRD recurrence after surgery in relation to the surgical procedure used.

Methods:

From 1998 to 2000, 735 consecutive PPV or SB for RRD were performed by the same surgical team. Patients with RRD that haven’t been already surgically treated for any retinal disease were included in this study. There was 271 PPV and 464 SB, and all patients were followed for at least 6 months. Twenty-one variable were studied by univariate analysis. The variables linked with recurrence were included in a Cox model.

Results:

The rate of RRD recurrence after the first treatment was 30% (222 of 735) mainly due to stages B, C and D (55%, 77 of 140). The entire rate of failure in reattaching retina was 6% (46 of 735) after one to three surgical procedures, and 3.5% for stages 0 or A (22 of 595). Univariate analysis showed factors that were statistically linked with recurrence or failure. Multivariate analysis of the overall population showed the only factors that were independent for development of recurrence or failure.

Conclusion:

The prognosis of RRD is mutifactorial and Cox model with multivariate analysis may be useful for the assessment of the 6-month prognosis in patients with RRD after first curative surgical treatment by vitrectomy or scleral buckling.