RESULTS OF PRIMARY RETINAE REATTACHMENT SURGERY - A PROSPECTIVE AUDIT

Purpose: To define the current success rate of primary retinal detachm ent repair at one centre. Methods: One hundred and fifty-three consecu tive patients undergoing surgery for primary retinal detachments over a 6 month period were studied prospectively. Data sheets were complete d immediately after surgery and at final follow-up, One hundred and tw enty-seven patients completed 6 months of followup. Follow-up data on the remainder were obtained from the referring unit or directly from t he patients by telephone. The term primary success was used to describ e persisting retinal reattachment after a single operation, Multiple l ogistic regression was carried out to establish factors associated,vit h failure. Results: One hundred and twenty-three patients (80%) had pe rsisting retinal reattachment after a single procedure, Of the 30 pati ents who required further surgery, in 5 the retina remained detached a t final follow-up, The final anatomical success rate was 97%, New or m issed breaks were the major causes of failure of primary surgery. Fail ure of primary surgery was associated with the presence of highly elev ated breaks (P = 0.11, p = 0.03). No other pre-operative factors appea red to predict failure to reattach the retina. Conclusions: Comparison of these results with those of a previous audit carried out at this h ospital 23 years ago suggests little improvement in the success rate o f primary surgery (75% vs 80%). The improvement in final retinal reatt achment has been rather greater (from 88% to 97%). The major impact of recent technical advances in retinal reattachment surgery has been on the success rate of reoperations after failed primary surgery.