CHARACTERISTICS AND SURGICAL OUTCOMES OF RHEGMATOGENOUS RETINAL DETACHMENT IN OLDER ADULTS: A Multicenter Comparative Cohort Study.

Abstract

PURPOSE:

To describe characteristics and outcomes of primary rhegmatogenous retinal detachment in older adults (age ≥ 80).

METHODS:

Consecutive patients with rhegmatogenous retinal detachment undergoing pars plana vitrectomy (PPV), scleral buckling (SB), or PPV/SB in the Primary Retinal Detachment Outcomes Study were evaluated. Outcome measures included single surgery anatomic success and visual acuity.

RESULTS:

Of 2,144 patients included, 125 (6%) were 80 years or older. Compared with younger patients (age 40-79), older adults were more likely to be pseudophakic (P < 0.001), have macula-off detachments (P < 0.001), and have preoperative proliferative vitreoretinopathy (P = 0.02). In older adults, initial surgery was PPV in 73%, PPV/SB in 27%, and primary SB in 0%. Single surgery anatomic success was 78% in older adults compared with 84% in younger patients (P = 0.03). In older adults, single surgery anatomic success was 74% for PPV and 91% for PPV/SB (P = 0.03). The final mean logMAR was lower for older adults (0.79 [20/125] vs. 0.40 [20/40], [P < 0.001]). In older adults, the final mean logMAR for eyes that underwent PPV was 0.88 (20/160) compared with 0.50 (20/63) for PPV/SB (P = 0.03).

CONCLUSION:

Octogenarians and nonagenarians presented with relatively complex pseudophakic rhegmatogenous retinal detachments. Single surgery anatomic success and visual outcomes were worse compared with younger patients, and PPV/SB had better outcomes compared with PPV alone.

• Authors: Samir N Patel, Matthew R Starr, Anthony Obeid, Edwin H Ryan, Claire Ryan, Nora J Forbes, Rebecca R Soares, Michael Ammar, Luv G Patel, Antonio Capone Jr, Geoffrey G Emerson, Daniel P Joseph, Dean Eliott, Carl D Regillo, Omesh P Gupta, Jason Hsu, Yoshihiro Yonekawa, Primary Retinal Detachment Outcomes (PRO) Study Group
• Journal: Retina (Philadelphia, Pa.) (Retina) Vol. 41 Issue 5 Pg. 947-956 (May 01 2021) ISSN: 1539-2864 [Electronic] United States
• PMID: 32858667 (Publication Type: Comparative Study, Journal Article, Multicenter Study, Observational Study)

Topics

• Adult
• Age Distribution
• Age Factors
• Aged
• Aged, 80 and over
• Endotamponade (methods)
• Follow-Up Studies
• Humans
• Intraoperative Period
• Middle Aged
• Pseudophakia (complications, physiopathology)
• Retinal Detachment (complications, diagnosis, surgery)
• Retrospective Studies
• Treatment Outcome
• Visual Acuity (physiology)
• Vitrectomy (methods)