Changing concepts of failures after retinal detachment surgery
W. F. Rachal and T. C. Burton
One thousand eighty-eight consecutive operations for retinal detachment
were analyzed to determine the influence of current methods of examination
and treatment on failures following surgery. The majority of failures were
produced by preretinal membranes formation (33%) and massive preretinal
retraction (27%). Other causes of failure included undetected retinal
breaks (13%), inadequate scleral buckel (10%), new retinal breaks (8%),
inadequate chorioretinal reaction (7%), and iatrogenic retinal breaks (2%).
Primary operations yielded an initial cure rate of 76%. Successful
reoperations raised the final cure rate to 89%. Reoperations were
associated more frequently with preretinal membrane formation and chance of
recognition and management of preretinal membrane formation. Except for new
retinal tears and massive preretinal retraction, surgical failures can be
avoided by improved utilization of current examination and operative
techniques.
