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¹Göz Eğitim ve araştırma Hastanesi 2. Göz Kliniği
²Beyoğlu Göz Eğitim ve Araştırma Hastanesi Purpose: The aim of this study was to investigate the causes of recurrent retinal detachments after conventional detachment surgery and the results of reoperations.
Methods: 106 eyes of 105 patients had conventional retinal detachment surgery in Beyoğlu Eye Education and Research Hospital between January 1998 and June 2001. In 25 of 106 eyes recurrent retinal detachments developed. We recorded the etiologies of recurrence in these 25 eyes. These eyes had different combinations of the following procedures; additional local indentation, change of the position of local indentation, subretinal fluid drainage, intravitreal air or gas injection, cryopexy, postoperative laser photocoagulation. We examined anatomic success rates after the second operation.
Results: In these 25 eyes we found that causes of recurrence was: Ineffective indentation in 11eyes(%44), missed retinal breaks in 5 eyes(%20), inappropriate localization of indentation in 4 eyes (%12), new break formation in 1 eye (%4), retinal incarseration in 1 eye (%4), subretinal hemorrhage that extends up to macula in 1 eye (%4), recurrence after anterior vitrectomy in 1 eye (%4), scleroretinal tear in 1 eye (%4). We performed additional local indentation procedure in 6 eyes, additional local indentation procedure and laser photocoagulation in 3 eyes, additional local indentation procedure and cryopexy in 3 eyes, additional local indentation procedure and laser photocoagulation and intravitreal air injection in 2 eyes, local indentation change and subretinal fluid drainage and cryopexy in 2 eyes, local indentation change and air injection and laser photocoagulation in 1 eye , air injection in 1 eye, gas(SF6) injection and cryopexy in 1 eye, vitrectomy in 3 eyes and local indentation reposition+intravitreal gas/air injection and subretinal fluid drainage in 3 eyes. For 9 of these 25 eyes vitrectomy was considered as a secondery or tertiary operation. In the first operation we had anatomically good results in 81 of 106 eyes (%76), we had succes in additional 16 eyes (%91,5) with conventional redetachment surgery.
Conclusion: Classical detachment surgery can be repeated in recurrent retinal detachments after the first conventional surgery. Keywords : Rhegmatogenous retinal detachment, proliferative vitreoretinopathy, recurrent rhegmatogenous retinal detachment