Outcomes in Recurrent Rhegmatogenous Retinal Detachment Repair: Does Scleral Buckling at Primary or Secondary Surgery Impact Results?

Mélanie Hébert, Jérôme Garneau, Sihame Doukkali, Serge Bourgault, Mathieu Caissie, Éric Tourville, Ali Dirani Department of Ophthalmology, Hôpital du Saint-Sacrement, CHU de Québec – Université Laval, Quebec City, CanadaCorrespondence: Ali Dirani, Department of Ophthalmology, Hôpital du Saint-Sacrement, 1050 Ste-Foy Street, Quebec City, QC, G1S 4L8, Canada, Tel +1-418 525-4444, Email [email protected]/Objectives: To analyze outcomes in recurrent rhegmatogenous retinal detachment (re-RRD) repair using pars plana vitrectomy (PPV) combined with scleral buckle (SB) at the first or second surgery.Subjects/Methods: Patients with primary uncomplicated RRD at initial presentation who were operated for re-RRD between 2014 and 2018 were included in this retrospective cohort study (n = 127). Patients were compared based on first and second surgery sequence: PPV then PPVSB (PPV-PPVSB: n = 51, 40%), or PPVSB then PPV (PPVSB-PPV: n = 76, 60%). Anatomical and functional outcomes were evaluated with second surgery success (2SS) defined as absence of reoperation after the second surgery and final pinhole visual acuity (PHVA) in logarithm of the minimum angle of resolution (logMAR), respectively.Results: Mean age at initial presentation was 65.7 years. There were 78 (61%) men and 56 (44%) pseudophakic patients. Median [Q1, Q3] baseline PHVA in logMAR was 0.70 [0.18, 2.30]. SB at first or second surgery did not significantly alter 2SS (PPV-PPVSB: 38, 75% vs PPVSB-PPV: 57, 75%; p = 1.00) or silicone oil use at second surgery (PPV-PPVSB: 18, 35% vs PPVSB-PPV: 36, 47%; p = 0.40). At final follow-up, PHVA did not significantly differ by sequence (p = 0.16).Conclusion: In re-RRD repair, SB at first or second surgery did not alter 2SS and final PHVA.Keywords: rhegmatogenous retinal detachment, recurrent retinal detachment, pars plana vitrectomy, scleral buckle, anatomic success, visual acuity