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

• Published in: Retina (Philadelphia, Pa.) Vol. 41; no. 5; p. 947
• Main Authors: Patel, Samir N, Starr, Matthew R, Obeid, Anthony, Ryan, Edwin H, Ryan, Claire, Forbes, Nora J, Soares, Rebecca R, Ammar, Michael, Patel, Luv G, Capone, Jr, Antonio, Emerson, Geoffrey G, Joseph, Daniel P, Eliott, Dean, Regillo, Carl D, Gupta, Omesh P, Hsu, Jason, Yonekawa, Yoshihiro
• Format: Journal Article
• Language: English
• Published: United States 01.05.2021
• ISSN: 1539-2864
• DOI: 10.1097/IAE.0000000000002969

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