Characteristics and Surgical Outcomes of Rhegmatogenous Retinal Detachment in Older Adults: A Multicenter Comparative Cohort study
Retina (Philadelphia, Pa.)
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.
Patel SN, Starr MR, Obeid A, Ryan EH, Ryan C, Forbes NJ, Soares RR, Ammar M, Patel LG, Capone A Jr, Emerson GG, Joseph DP, Eliott D, Regillo CD, Gupta OP, Hsu J, Yonekawa Y; Characteristics and Surgical Outcomes of Rhegmatogenous Retinal Detachment in Older Adults: A Multicenter Comparative Cohort study. Retina. 2021 May 1;41(5):947-956. doi: 10.1097/IAE.0000000000002969. PMID: 32858667.