Surgical Failure Following Primary Retinal Detachment Surgery by 23-Gauge Vitrectomy: Preoperative Risk Factors Assessment

Aim of Study: To assess the preoperative risk factors implicated in increasing the risk of surgical failure in primary retinal detachment surgery using the 23-G vitrectomy platform. Methods: Eighty eyes suffering from primary rhegmatogenous retinal detachment were treated with 23-gauge transconjunctival vitrectomy. A comprehensive ophthalmological examination including the duration of the detachment and the grading of PVR, if present, was performed preoperatively. Three months post tamponade removal the retinas were examined and the preoperative risk factors for surgical failure were analyzed. Results: The overall primary success rate of retinal reattachment is 72.5% (58/80 eyes). Backward logistic multiregression analysis identified significant independent predictors of redetachment (p<0.01, Hosmer-Lemeshow, «2: 7.593, p=0.474): Duration of detachment and preoperative visual acuity. Specifically, for every day more of duration of detachment, the odds of redetachment increased by a factor of 1.007 (95% Confidence Interval, CI: 1.000 to 1.015, p<0.01). Likewise, for every day more of duration of detachment, the odds of redetachment was increased by a factor of 8.840 if a preoperative visual acuity of HMBP or worse was present (95% CI 2.507 to 31.102, p=0.05). Conclusion: Proliferative vitreoretinopathy (PVR) grade C, preoperative visual acuity of HMBP or less and the duration of the retinal detachment were risk factors for failure of retinal reattachment using 23-gauge transconjunctival vitrectomy.