Incidence and Impact of Outer Retinal Folds After Pars Plana Vitrectomy for Primary Rhegmatogenous Retinal Detachment Repair.

Purpose: To determine the incidence, risk factors, and visual impact of outer retinal fold formation after pars plana vitrectomy (PPV) for macula-involving rhegmatogenous retinal detachment (RRD).

Methods: A retrospective cohort study was performed of patients who had PPV with or without scleral buckling between 2011 and 2021 at a single tertiary referral center. Inclusion criteria were macular optical coherence tomography (OCT) performed within 6 weeks of PPV. Eyes with silicone oil tamponade or redetachment within 12 weeks of repair were excluded. Demographics, ocular characteristics, surgical technique, visual acuity (VA), and OCT data were analyzed.

Results: This study included 154 eyes. Outer retinal folds developed in 19.2% of eyes that had OCT within 6 weeks of PPV. The mean time to resolution of an outer retinal fold was 131.9 days. Although eyes with outer retinal folds had worse preoperative vision, there was no difference in the final VA between the groups (preoperative: 20/1099 vs 20/230; P = .003) (12 months postoperative: 20/49 vs 20/46; P = .73). There was a trend toward more superior RRD in patients with outer retinal folds (P = .10).

Conclusions: In this study, the incidence of outer retinal folds after PPV for macula-involving RRDs was lower than previously reported. Outer retinal folds that developed soon after surgery resolved quickly, and their presence or absence was not associated with the final VA.