Incidence and risk factors for recurrence after surgical treatment of rhegmatogenous retinal detachment: a retrospective cohort study.

Abstract

Background: Rhegmatogenous retinal detachment (RRD) is a vision-threatening ophthalmic emergency requiring prompt surgical intervention. Despite advancements in surgical techniques, recurrence remains a significant challenge, leading to additional surgeries and poorer visual outcomes. This study aimed to evaluate the incidence and risk factors for RRD recurrence following surgical repair in an Egyptian tertiary care setting.

Methods: A retrospective cohort study was conducted at Alexandria Main University Hospital, Egypt, including 134 patients who underwent RRD surgery (pars plana vitrectomy [PPV] or scleral buckling [SB]) between March and September 2023. Demographic, clinical, and surgical variables were evaluated. Recurrence was defined as anatomical detachment after initial surgical success within a 6-month follow-up period. Statistical analyses included chi-square tests and multivariate logistic regression to identify independent risk factors.

Results: The recurrence rate was 24.6%, with early recurrence (≤ 6 weeks) occurring in 14.9% of cases. PPV had a significantly higher recurrence rate (34.8%) compared to SB (19.3%) (p = 0.049). Univariate analysis identified right eye laterality (p = 0.02), high myopia (p = 0.015), proliferative vitreoretinopathy (PVR) (p < 0.001), and ocular comorbidities (p = 0.018) as significant risk factors. Multivariate analysis confirmed right eye laterality (OR: 3.7, p = 0.016), high myopia (OR: 0.34, p = 0.04), and PVR (OR: 0.15, p = 0.005) as independent predictors. Surgeon experience significantly influenced outcomes in univariate analysis (p = 0.001), but not in adjusted models.

Conclusions: RRD recurrence remains prevalent occurring in nearly one-quarter of repaired RRD cases, predominantly within the early postoperative period. Surgical technique, laterality, and ocular characteristics significantly impacted recurrence risk. These findings highlight the need for individualized surgical planning and enhanced surveillance in high-risk patients, particularly during the critical first postoperative weeks.