RETINAL RE-DETACHMENT IN VITRECTOMISED EYES FOLLOWING CATARACT SURGERY

Pars plana vitrectomy (PPV) with gas tamponade is known to precipitate cataract progression, particularly when performed for retinal detachment (RD). While cataract surgical complications in previously vitrectomised eyes are well-studied, limited literature exists on the rate of retinal re-detachment following cataract extraction (CE) in eyes with prior PPV for RD. The following study aims to assess the incidence and outcomes of re-RD following CE in patients with a history of PPV for RD. 

Moorfields Eye Hospital, London. 

A retrospective review was conducted on consecutive CE’s at Moorfields Eye Hospital NHS Foundation Trust between January 1, 2015, and March 15, 2022. Included were patients with prior PPV for RD. Exclusion criteria included multiple vitrectomies before CE, combined procedures with phacoemulsification, and non-phacoemulsification CE’s. Data on demographics, the interval from PPV to CE, and subsequent retinal detachment were collected, with a minimum of one-year follow-up post CE. Statistical analysis was performed using logistic regression.

Out of 110,670 patients who had CE, 1,808 had prior RD repair. Within this group, 44 patients (2.4%) experienced re-detachment following CE. This rate was significantly higher than the 0.34% incidence of first RD after CE (χ² = 203.61, p < 0.01). The mean final logMAR BCVA for patients with RD repair pre-CE was 0.15, compared to 0.5 for those who had RD repair post-CE.. The mean interval from CE to re-detachment was 573 days.

This study highlights that the rate of re-detachment  following CE is still significant despite eyes having undergone vitrectomy and RD repair previously. Final visual acuity was notably lower in those patients who had RD post CE compared to those with RD repair before CE.