Surgical outcome and risk stratification for primary retinal detachment repair: results from the Scottish Retinal Detachment study

Abstract

Consistent with previous series, the overall early success rate of RRD repair was 80% after one operation. The type of surgical repair did not influence overall success rates. Significant predictors of failure are the presence of preoperative proliferative vitreoretinopathy of any grade and the extent of detachment. The analytical value of current classification systems in predicting failure is most useful in complex RRDs.

Impact of Metamorphopsia on Quality of Life after Successful Retinal Detachment Surgery

“…Despite excellent surgical success rates, with an anatomical reattachment reaching up to 94% [1, 2], visual recovery varies after rhegmatogenous retinal detachment (RD). The postoperative quality of vision may be disappointing for both the patient and the surgeon [3].…”

Royal College of Ophthalmologists' National Database Study of Vitreoretinal Surgery

“…In the UK, PPV surgery is currently the dominant technique used to treat RD and SB is increasingly reserved for non-complex RD in the absence of posterior vitreous separation in young patients. 13 In contrast to PPV or SB, combined PPV + SB surgery had the highest rates of failure for all grades of surgeon in our series. Although the number of these cases is relatively small making it difficult to draw firm conclusions, case selection is likely to explain the higher failure rate in this group as this technique is disproportionately used to treat more complex cases.…”

“…Significant variation in reported primary RD failure exists. [10][11][12][13][14][15][16][17][18][19] This range may be due to variations in patient selection including surgical complexity, the definition of primary RD failure, the timeframe for reporting failure, and the inclusion or exclusion of cases with silicone oil in situ. A recent nationwide database study from Denmark found a 22% re-operation rate after RD surgery, using a large subset of 6,522 eyes of which 29.5% received silicone oil injection.…”

“…Eyes that underwent pneumatic retinopexy were also excluded from this study because this technique is performed in only a very small proportion of cases in the UK 13 and the numbers were too small to allow meaningful analysis of inter-surgeon variation. Operations recorded on the BEAVRS registry with an 'unknown' outcome were also excluded, as were operations (from all sources) performed within 6 months of data extraction, to allow sufficient time for follow up given that 97.5% of primary failures occur within the first 6 months and therefore a shorter duration of follow-up can under-estimate surgeons' failure rates.…”

“…The Royal College of Ophthalmologists has recommended primary RD success rate as one of the benchmark indicators for fitness to practise vitreoretinal surgery, although to date no acceptable boundaries for case mix adjusted RD success rates have been defined. 9 Several studies have documented the success rate of primary RD surgery [10][11][12][13][14][15][16][17][18][19][20] but few have analysed inter-surgeon variation and those that did included only experienced surgeons 16 or a few centres reporting only one technique: PPV. [17][18][19] The UK National Health Service (NHS) provides an ideal environment for "real-world" studies of vitreoretinal surgery outcomes.…”