Outcomes of Symptomatic Retinal Breaks Treated With Laser Retinopexy

Purpose: To report the rates of rhegmatogenous retinal detachment (RRD), retreatment laser retinopexy, clinical associations, fellow eye laser retinopexy, and outcomes of initial laser retinopexy for symptomatic retinal break(s). Methods: This retrospective, interventional consecutive case series included data on patient demographics, best-corrected visual acuity, and baseline clinical features of retinal breaks. Univariable and multivariable logistic regressions with generalized estimating equations were performed to identify factors associated with subsequent RRD and any additional treatment. Results: Among 600 eyes (572 patients) treated for retinal breaks, an RRD occurred in 43 eyes (7.2%), most commonly as a macula-on RRD (37 eyes [86.0%]). Additional laser retinopexy was performed in 66 eyes (11%), including 53 eyes (80.3%) for original break(s). Risk factors for RRD after initial laser included multiple breaks (odds ratio [OR], 3.94; 95% CI, 1.4-11.2; P = .010), pseudophakia (OR, 3.15; 95% CI, 1.4-6.9; P = .004), and vitreous hemorrhage (OR, 2.31; 95% CI, 1.04-5.14; P = .038). Risk factors for additional laser retinopexy included multiple breaks (OR, 5.9; 95% CI, 2.4-14.2; P = .001), inferotemporal location (OR, 2.34; 95% CI, 1.0-5.4; P = .047), and fellow-eye laser retinopexy (OR, 7.78; 95% CI, 1.63-37.1; P = .01). Outcomes did not differ significantly between eyes treated by residents and attendings ( P > .47). Conclusions: RRD occurs in a low, but not trivial, percentage of patients after treatment of a symptomatic retinal break, and additional treatment in the same eye after initial treatment is often performed for the same break or additional breaks. Regular follow-up after initial laser retinopexy is recommended for optimized outcomes.