Unplanned Reoperation following Vitreoretinal Surgery

Abstract

Purpose: To evaluate the incidence of unplanned return to the operating room following vitreoretinal surgery and assess the reasons. Methods: In this retrospective case series, medical records of all patients who underwent vitreoretinal surgery were reviewed to determine the incidence and reasons of early (<30 days postoperatively) and late (≥30 days postoperatively) unplanned reoperations after the surgery. Results: A total of 488 eyes of 468 patients with a mean age of 55.84 ± 18.23 years were included. Fourteen percent (68/488) of eyes required one or more unplanned reoperation following their primary surgery. These include 3.9% (19/488) for the early and 10.0% (49/488) for the late reoperation. The most common primary reason for baseline surgery was rhegmatogenous retinal detachment (RRD) without proliferative vitreoretinopathy (PVR, 38.2%), followed by RD with PVR (23.5%), and tractional RD (TRD, 19.1%). Unplanned reoperations were most common in RD with PVR (19.3%), RRD without PVR (17.2%), and TRD (14.4%). Overall, the most common reasons of the first unplanned reoperation were repeated RD with PVR (27.9%), repeated RD (19.1%), and the presence of silicone oil (SO) in the anterior chamber (AC) (10.3%). For early unplanned reoperations, SO in AC, postoperative endophthalmitis, and persistent hyphema were the most common causes. Repeated RD with PVR was the most prevalent cause of late unplanned reoperations (34.7%). In the multivariate analysis, preoperative best-corrected visual acuity (BCVA) was significantly lower in eyes with unplanned reoperation than in eyes without (P = 0.011). Conclusions: Unplanned reoperation following vitreoretinal surgery is not very common, and occurs mostly in the setting of PVR, RRD, and TRD. Lower preoperative BCVA may indicate an increased chance of future unplanned reoperation(s).