Incidence and Outcomes of Recurrent Retinal Detachment after Cataract Surgery in Eyes with Prior Retinal Detachment Repair

Abstract

ObjectiveTo investigate the incidence and outcomes of recurrent retinal detachment (RD) after cataract extraction. DesignRetrospective case series. SubjectsPhakic eyes with RD that were successfully repaired with pneumatic retinopexy (PR), scleral buckle (SB), pars plana vitrectomy (PPV), or combined PPV/SB and subsequently underwent cataract surgery. MethodA retrospective review of phakic eyes that underwent successful RD repair followed by subsequent cataract surgery between April 2012 and January 2023 was performed. Patients with multiple retinal detachment surgeries prior to cataract extraction and those with silicone oil tamponade before cataract surgery were excluded. Eyes that redetached were matched 2:1 with eyes that did not redetach after cataract surgery. Main outcome measuresIncidence of redetachment after cataract surgery as well as visual and anatomic outcomes at 6 months after first redetachment and at the final visit. ResultsOf 4833 phakic eyes at the time of initial RD, 1893 patients (39.2%) underwent cataract surgery. After applying exclusion criteria, 763 patients were included. The mean (standard deviation, SD) duration of follow-up was 48.4 (29.1) months. The overall incidence of retinal redetachment after cataract surgery was 2.5% (19/763 eyes). The rate of redetachment based on the type of initial RD repair was 9.1% (1/11), 5.3% (2/38), 2.8% (9/317), and 1.8% (7/397) for PR, SB, PPV, and combined PPV/SB, respectively (P=0.24). The median (interquartile range, IQR; range) duration between the cataract surgery and first redetachment was 301 (104-1222; 8-2760) days. Single surgery anatomic success (SSAS) for the RD repair after cataract surgery was achieved in 17 eyes (89.5%) at 3 months and 14 eyes (73.7%) at 6 months and at the final visit. Final anatomic success rate for reattachment was 100% (19/19). The median (IQR) logarithm of the minimal angle of resolution (logMAR) visual acuity at the final visit was 1.00 (0.18-2.00, Snellen equivalent, 20/200) with significant decrease compared to vision after cataract surgery (0.18 (0.10-0.48), 20/30) (P=0.001). ConclusionRecurrent RD was not uncommon in patients with a prior history of RD repair after cataract extraction. Reoperation resulted in relatively favorable anatomic success but there were declines in visual acuity.