Surgical Outcomes of Rhegmatogenous Retinal Detachment and Fellow Eye Involvement in Adolescent and Young Adult Patients

Abstract

To investigate the associations, fellow eye retinal tear or detachment, and surgical outcomes of rhegmatogenous retinal detachments (RRDs) in young adults. Retrospective Consecutive Case Series. Patients ≤30 years old who underwent surgical repair for RRD between 2014 and 2021 at a single practice. The mean age was 23.85 years (Range 12-30 years old). Data collected included demographics, pre-operative clinical features of the RRD, visual acuity (VA), type of surgery performed, anatomic outcomes, optical coherence tomography (OCT) findings, fellow eye retinal tear or detachment, and post-operative complications. Post-operative VA and single surgery anatomic success rate. 101 patients (109 eyes) were included. 67 patients (74 eyes) and 17 patients (19 eyes) were followed for at least 1 year and 5 years respectively. The most common associations were myopia (66 eyes, 60.6%), trauma (8 eyes, 7.3%), and prior ocular surgery (7 eyes, 6.4%). Median pre-op Snellen VA was 20/70. The macula was attached in 31 eyes. Scleral buckle alone (SB) was performed in 75 eyes, PPV+SB in 27 eyes, PPV alone in 6 eyes, and Cryo-PnR in 1 patient. Single surgery anatomical success was 88.7% for SB, 89.7% for PPV+SB and 75% for PPV. The median final post-operative Snellen VA was 20/50. Twelve patients presented with bilateral RRDs and sequential surgery was performed in 8 patients followed by 4 patients who underwent surgery with fellow eye laser barricade. Fourteen eyes (12.8%) developed a retinal tear or detachment in the fellow eye with a mean interval of 8 months from presentation. Of the 17 patients that were followed for at least 5 years, 3 patients (17.6%) developed a fellow eye retinal tear or detachment. After initial anatomical success, 6 eyes (5.5%) developed PVR. The most common association of RRD in this study was myopia. SB alone was the most common surgical intervention. However, outcomes were generally favorable with SB only and PPV+SB. Surgeons and patients should be aware of the risk of bilateral retinal detachment and the risk of fellow eye retinal tear and detachment. These patients require long term surveillance in both eyes.