Results of primary retinal reattachment surgery: a prospective audit.
OBJECTIVE
To define the current success rate of primary retinal detachment repair at one centre.


METHODS
One hundred and fifty-three consecutive patients undergoing surgery for primary retinal detachments over a 6 month period were studied prospectively. Data sheets were completed immediately after surgery and at final follow-up. One hundred and twenty-seven patients completed 6 months of follow-up. Follow-up data on the remainder were obtained from the referring unit or directly from the patients by telephone. The term primary success was used to describe persisting retinal reattachment after a single operation. Multiple logistic regression was carried out to establish factors associated with failure.


RESULTS
One hundred and twenty-three patients (80%) had persisting retinal reattachment after a single procedure. Of the 30 patients who required further surgery, in 5 the retina remained detached at final follow-up. The final anatomical success rate was 97%. New or missed breaks were the major causes of failure of primary surgery. Failure of primary surgery was associated with the presence of highly elevated breaks (beta = 0.11, p = 0.03). No other pre-operative factors appeared to predict failure to reattach the retina.


CONCLUSIONS
Comparison of these results with those of a previous audit carried out at this hospital 23 years ago suggests little improvement in the success rate of primary surgery (75% vs 80%). The improvement in final retinal reattachment has been rather greater (from 88% to 97%). The major impact of recent technical advances in retinal reattachment surgery has been on the success rate of reoperations after failed primary surgery.
Sullivan
P M
PM
Vitreoretinal Unit, Moorfields Eye Hospital, London, UK.
Luff
A J
AJ
Aylward
G W
GW
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D005500:Follow-Up Studies; D006801:Humans; D008131:London; D008485:Medical Audit; D008875:Middle Aged; D011183:Postoperative Complications; D011184:Postoperative Period; D011446:Prospective Studies; D012086:Reoperation; D012163:Retinal Detachment / Q000601:surgery*; D017211:Treatment Failure; D014792:Visual Acuity