The Results of the Treatment of the Recurrent “Inferior” Retinal Detachment Depending on the Volume of Surgical Intervention

Abstract

Purpose: to analyze the results of the treatment recurrent «inferior» retinal detachments (RD) depending on the volume of surgical intervention.Patients and methods. 81 patients (81 eyes) with recurrent «inferior» RD were included in this retrospective study. Groups were identified depending on the volume of surgical treatment of recurrents RDs: scleral buckling (SB), pars plana vitrectomy (PPV), combined surgery: PPV with SB, PPV with retinotomy (RT), including the use of perfluorocarbon fluid (PFCL). The volume of surgical treatment was assessed before recurrent RD, after the first and second recurrent «inferior» RD, the distribution of the grade and type of proliferative vitreoretinopathy (PVR) complicating these recurrents RD with different treatment tactics, analyzed the functional results and anatomical success (retinal reattachment) after surgical treatment of the first and second recurrents RD.Results. Primary anatomical success was achieved in 304 from 385 patients (79 %). In 81 cases, the first recurrent RD was detected (21 %). Surgical treatment of the first recurrent RD included: in 39 cases (48 %) — PPV; in 9 cases (11 %) — PPV with SB; in 13 cases (16 %) — PPV with RT. In 20 cases (25 %) for short-term tamponade with PFCL was used when performing PPV with RT. The second recurrent RD occurred in 42 cases, which accounted for 52 % of the first recurrent RD. The anterior type of PVR was in all cases (100 %). All patients underwent repeated surgery: PPV (100 %), of which in 15 cases (35.7 %) — PPV with RT; the use of short-term postoperative tamponade with PFCL was in 18 cases (42.9 %); additional SB — in 9 cases (21.4 %). Anatomical success was achieved in 100 % of cases after surgical treatment of the second recurrent RD, but in 8 cases (19 %) a retinal redetachment occurred.Conclusion. The increase in PVR continues to be the main cause of recurrent RD. In patients with recurrent «inferior» retinal detachments, grade C PVR type 4, 5, the additional use of SB for PPV, RT and the use of PFCL as a short-term postoperative tamponade allows achieving better results (functional and anatomical). During surgery of the second recurrent RD, when there are pronounced changes in the retina, performing SB is impractical, the alternative is RT.