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Risk factors for recurrence and failure
in phakic versus pseudophakic rhegmatogenous retinal detachment

Frank Becquet, Jean-François Le Rouic

Nantes, France

Purpose : The aim of this study was to evaluate frequency and risk factors of retinal recurrence and failure in relation to the lens status (phakic or pseudophakic eye).
Methods : This retrospective study included 3098 patients who consecutively underwent surgical repair (primary posterior vitrectomy and/or scleral buckling technique) for retinal detachment (RD) performed by the same surgical team. Only patients with primary RD were included in this study. 10 clinical variables were studied by univariate and multivariate analysis. Cell-flare meter laser data were obtained for measurement of anterior chamber inflammation. Minimal follow-up was six months.
Results : The rate of RD recurrence after the first treatment was 8% (249 of 3098), with a final failure rate of 3% (95 of 3098) mainly due to PVR grade B, C and D. Risk factors for recurrence were the following : complicated (p<0.0001) and uncomplicated (p<0.0001) pseudophakic eye specially in grade A PVR (p=0.0005), grade B PVR (p=0.04), and grade C PVR (p=0.03) ; Yag laser capsulotomy in the 6 months before RD (p=0.01). Risk factors for failure were the following : complicated (p<0.0001) and uncomplicated (p<0.0001) pseudophakic eye ; cataract surgery in the 6 months before RD (p=0.0009) ; grade A PVR in uncomplicated pseudophakic eyes (p=0.0001), and grade B PVR in complicated pseudophakic eyes (p=0.04). Inflammation was statistically linked with retinal reccurrence and failure (p=0.003).
Conclusion : Pseudophakic eyes are overall frail in comparison with phakic ones when a RD arise, probably because of anatomical and hemato-ocular disturbances. This Cox model may be useful to predict the probability of developing retinal recurrence or failure and may be used to identify those at risk.