Characteristics and Surgical Outcomes of Rhegmatogenous Retinal Detachment in Older Adults: a Multicenter Comparative Cohort Study.

PURPOSE To describe characteristics and outcomes of primary rhegmatogenous retinal detachment (RRD) in older adults (age ≥80). METHODS Consecutive patients with RRD 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 (SSAS) and visual acuity (VA). RESULTS Of 2144 patients included, 125 (6%) were 80 years or older. Compared to younger patients (age 40-79), older adults were more likely to be pseudophakic (P<.001), have macula-off detachments (P<.001), and have pre-operative proliferative vitreoretinopathy (P=.02). In older adults, initial surgery was PPV in 73%, PPV/SB in 27%, and primary SB in 0%. SSAS was 78% in older adults compared to 84% in younger patients (P=.03). In older adults, SSAS was 74% for PPV and 91% for PPV/SB (P=.03). Final mean logMAR was lower for older adults (0.79 [20/125] vs 0.40 [20/40], [P<.001]). In older adults, final mean logMAR for eyes that underwent PPV was 0.88 (20/160) compared to 0.50 (20/63) for PPV/SB (P=.03). CONCLUSION Octogenarians and nonagenarians presented with relatively complex pseudophakic RRDs. SSAS and visual outcomes were worse compared to younger patients, and PPV/SB had better outcomes compared to PPV alone.