Characteristics of pseudophakic retinal detachment and risk factors of recurrence

• Published in: Archivos de la Sociedad Española de Oftalmología (English ed.) 2024-09, Vol.99 (9), p.365-372
• Main Authors: Gibelalde, A., Pinar-Sueiro, S., Ibarrondo, O., Ruiz Miguel, M., Martínez Soroa, I., Mendicute, J.
• Format: Article
• Language: English
• Subjects: Desprendimiento de retina; Facoemulsificación; Phacoemulsification; Pseudofaquia; Pseudophakic; Recidiva; Relapse; Retinal detachment
• ISSN: 2173-5794; 2173-5794
• DOI: 10.1016/j.oftale.2024.05.009

The present study was designed to gain knowledge about the prognostic factors and evolution of pseudophakic retinal detachment (PRD) and to analyse the main characteristics of PRD, such as the mean time to retinal detachment following cataract surgery, as well as the clinical factors associated with the risk of recurrence and worse anatomical and functional outcomes. This was a retrospective monocentric study of 330 patients with PRD who underwent surgery between 2012 and 2020. All patients were pseudophakic and were referred for retinal detachment surgery at Donostia University Hospital (Terciary Hospital, Spain). The mean age of the patients at the time of phacoemulsification was 63.06 ± 10.8 years, and 49.09% of them had moderate myopia [axial length (AL) (23.5–26.5 mm)]. In our series, macular detachment was evident in 69.09% (n = 228) of the patients. The mean time that elapsed between phacoemulsification and PRD surgery was 4.04 ± 4.17 years, which was reduced by half in the event of surgical complications (2.24 ± 2.65). The rate of PRD was 28.79%. The anatomical results in terms of retinal reapplication were better with the combination of vitrectomy and scleral buckling (83.1% vs. 70.5%) (p = 0,127) compared with vitrectomy. The variables associated with a higher risk of recurrence were male sex (hazard ratio (HR) = 1.75), macular detachment (HR = 2.00) and the presence of proliferative vitreoretinopathy (PVR) (HR = 3.21). PRD usually occurs within 4 years of phacoemulsification, although it may occur significantly earlier in the event of surgical complications. Macular involvement, PVR, and male sex are all associated with a higher risk of PRD recurrence. El presente ha sido diseñado para conocer los factores pronósticos y la evolución del desprendimiento de retina pseudofáquico (DRP) y analizar las principales características del DRP, como el tiempo medio hasta el desprendimiento de retina tras la cirugía de cataratas, así como los factores clínicos. asociado con el riesgo de recurrencia y peores resultados anatómicos y funcionales. Se trata de un estudio monocéntrico retrospectivo de 330 pacientes con desprendimiento de retina (DRP) intervenidos entre los años 2012 y 2020 en nuestro centro (Hospital Universitario de Donostia, España). La edad media de los pacientes al momento de la facoemulsificación fue de 63,06 ± 10,8 años, y el 49,09% de ellos presentaban miopía moderada [longitud axial (AL) (23,5-26,5 mm)]. En nuestra serie el desprendimiento