Outcomes of Rhegmatogenous Retinal Detachment Repair Following Infectious Endophthalmitis.

Abstract

To determine the incidence of and identify risk factors for redetachment in eyes that underwent rhegmatogenous retinal detachment (RRD) repair after infectious endophthalmitis. Retrospective chart review of patients who had RRD surgery following a diagnosis of endophthalmitis from 2008-2021 at a tertiary referral center. Demographic and clinical characteristics as well as operative details were collected. Subjects with prior RRD, trauma, keratoprosthesis, or less than 3 months of postoperative follow-up were excluded. Univariate logistic regression analyses were performed. Thirty-four eyes of 34 patients were included. Most subjects were male with a mean age of 60.1 years. Exogenous (58.8%) was more common than endogenous (41.2%) sources of endophthalmitis. Seventeen of 34 eyes (50.0%) experienced redetachment. Significant risk factors were infection with virulent organisms, hypotony, and postoperative proliferative vitreoretinopathy. Initial management with vitreous tap and/or vitrectomy, exogenous versus endogenous source, and surgical procedure were not associated with recurrent RRD. At final follow-up, 32 of 34 eyes (91.2%) were attached, though over one-third of these had silicone oil. Redetachment occurred in half of eyes that underwent surgical repair of RRD after endophthalmitis. Early vitrectomy, with or without prior vitreous tap, was not associated with a higher risk of redetachment and improved the likelihood of a positive culture result. Culture data can aid in risk stratification, as organism virulence was a risk factor for recurrent RRD. While visual outcomes were generally poor, the majority of retinas remained attached at the last visit.