Surgical Outcomes of Primary Noncomplex Rhegmatogenous Retinal Detachment in 20- to 45-Year-Old Young Adults.

Purpose: To analyze anatomic and visual outcomes of young adults with uncomplicated primary rhegmatogenous retinal detachment (RRD) treated with scleral buckle, pars plana vitrectomy (PPV), or combined PPV and scleral buckle.

Methods

Patients included in the Primary Retinal Detachment Outcomes study with a minimum of 6 months follow-up were evaluated in this multicenter interventional cohort study. Patients with complex RRDs were excluded. Primary outcomes were single surgery anatomic success and final visual acuity (VA).

Results

Scleral buckle was performed in 91 eyes (55%), PPV in 32 (19%), and combined PPV and scleral buckle in 42 (25%). Single surgery anatomic success rates were 79.3% for PPV alone, 83.7% for primary scleral buckle, and 92.7% for combined PPV and scleral buckle (analysis of variance, P = .25). When adjusting for potential risk factors, eyes that had PPV alone were more likely to redetach compared with those that had combined PPV and scleral buckle (hazard ratio [HR], 7.24, 95% CI, 1.25-42.1; P = .03), while rates of redetachment were similar in eyes that had scleral buckle alone and combined PPV and scleral buckle (HR, 3.24, 95% CI, 0.63-16.63; P = .16). However, eyes that had combined PPV and scleral buckle were less likely to result in good vision compared with eyes that had scleral buckle alone (odds ratio [OR], 0.26, 95% CI, 0.07-0.94; P = .04). Similarly, eyes that had PPV alone were less likely to obtain good vision compared with eyes that only had scleral buckle (OR, 0.20, 95% CI, 0.05-0.81; P = .02).

Conclusions

For young adults in this study, the best visual outcomes resulted from scleral buckle, and a higher single surgery success rate was found with combined PPV and scleral buckle.