Clinical and Demographic Risk Factors Associated with Recurrent and Fellow Eye Rhegmatogenous Retinal Detachments.

Abstract

Purpose: To identify clinical and surgical risk factors associated with recurrent rhegmatogenous retinal detachment (RRD) in the index eye and RRD in the fellow eye.

Methods: Retrospective observational study of adult patients who underwent RRD repair at two tertiary care centers over six years.

Results: Among 794 primary RRD patients, recurrence occurred in 20.5%, and RRD in the fellow eye was observed in 5.2%. Postoperative visual acuity significantly improved at one year (95% CI -0.44-0.30; P < 0.001). Higher recurrence rates were found in patients with prolonged symptom duration (P = 0.005), preoperative proliferative vitreoretinopathy (P = 0.006), and worse initial visual acuity (P < 0.001). Recurrences were most frequent within the first 90 days postoperatively, while fellow eye RRD primarily occurred after one year. Pneumatic retinopexy (PnR) (SE 0.37; 95% CI 1.07-4.64, P = 0.03) and the extent of detachment (SE 0.04; 95% CI 1.0-1.2; P = 0.005) were significant predictors of recurrence in multivariate analyses. Age (SE 0.01; 95% CI 1.01-1.05; P = 0.01) and male sex (SE 0.38; 95% CI 1.66-7.47; P = 0.001) were significant predictors for fellow eye RRD.

Conclusion: The study highlights PnR and detachment extent as significant predictors of RRD recurrence. It also identifies older age and male sex as risk factors for RRD in the fellow eye. Our findings emphasize the importance of risk stratification and recommend close monitoring during the first 90 days and beyond the one-year postoperative period.