Delayed-Onset Recurrent Retinal Detachment More Than One Year After Pneumatic Retinopexy, Scleral Buckle, or Vitrectomy for Primary Rhegmatogenous Retinal Detachment Repair: Incidence, Characteristics, and Outcomes

Purpose: To evaluate the incidence, causes, and outcomes of recurrent rhegmatogenous retinal detachment (RRD) occurring more than 12 months after the initial RRD repair. Methods: This retrospective case series examined patients who underwent primary pneumatic retinopexy (PnR), scleral buckle (SB), pars plana vitrectomy (PPV), or combined PPV/SB for primary RRD and were followed for at least 12 months. Patients treated with silicone oil were excluded. The primary outcome was the incidence of delayed recurrent RRD. Results: Of 3668 eyes included, 293, 545, 1839, and 991 eyes underwent PnR, SB, PPV, and PPV/SB, respectively, as the initial RRD repair. The mean follow-up length was 4.9 ± 2.6 (range, 1–11.9) years. Fifty-one eyes (1.4%) from 51 patients developed delayed re-detachment. The time to delayed re-detachment was 3.8 ± 3.0 years. The incidence was 4.4% after PnR, 2.8% after SB, 0.9% after PPV, and 0.6% after PPV/SB. The incidence was greatest after PnR and lowest after PPV/SB (P < 0.001). The causes of re-detachment included new tears (31 eyes [60.8%], of which 11 had new tears adjacent to the laser retinopexy used to treat the original break), proliferative vitreoretinopathy (11 eyes [21.6%]), and other (9 eyes [17.6%]). Reoperation resulted in anatomic success of 88.2% at 3 months and 98.9% at the final visit. Conclusion: Recurrence of RRD more than 12 months after initial surgery may occur in 1.4% of patients, with a higher incidence after PnR and a lower incidence after PPV and PPV/SB. Reoperation resulted in acceptable anatomic outcomes.