Vitreoretinal surgery on the fellow eye: A retrospective analysis of 18 years of surgical data from a tertiary center in England

• Published in: Indian journal of ophthalmology 2018-05, Vol.66 (5), p.681-686
• Main Authors: Fajgenbaum, Mark, Wong, Roger, Laidlaw, David, Williamson, Tom
• Format: Article
• Language: English
• Subjects: Age; Analysis; Care and treatment; Diabetes; Diabetes mellitus; Diabetic retinopathy; Eye; Eye surgery; Fellow eye; Gender; hazard; Life expectancy; Males; Nuclei; Ophthalmology; Original; Patients; Retina; retinal detachment; Retinopathy; risk; Risk factors; second eye; Surgery; Survival analysis; vitreoretinal surgery
• ISSN: 0301-4738; 1998-3689
• DOI: 10.4103/ijo.IJO_1176_17

Purpose: To determine the long-term incidence of fellow-eye surgical involvement in patients who have undergone first-eye vitreoretinal (VR) surgery for a variety of indications. This was a single-institution retrospective, consecutive series. Methods: Eighteen years of electronic surgical data were reviewed at our institution. All patients having surgery for the following indications were included: rhegmatogenous retinal detachment (RRD), macular hole (MH), epiretinal membrane (ERM), proliferative diabetic retinopathy (PDR), vitritis, and dropped nucleus. Primary outcome was the cumulative incidence of fellow-eye surgery at 10 years by Kaplan-Meier analysis. Results: Total follow-up was 29,629 patient-years. Cumulative incidence (± standard error) of fellow-eye surgery at 10 years was 7.2% ± 0.6% for RRD, 9.1% ± 1.3% for ERM, 7.5% ± 1.8% for MH, 30.6% ± 1.9% for PDR, 13.7% ± 2.9% for vitritis, and 2.8% ± 1.6% for dropped nuclei. The hazard for second-eye surgery was greatest in the early postoperative period after first-eye surgery for all indications. For RRD, the hazard was 2.7% ± 0.3% at year 1, 1.1% ± 0.2% at year 2, and 0.5% ± 0.2% at year 5. Risk factors for fellow-eye involvement for RRD were younger age (P < 0.001) and male gender (P < 0.01). Conclusion: We report the long-term risk of fellow-eye involvement in various VR pathologies, which is important in counseling patients regarding their risks as well as planning service provision.