To investigate the causes of recurrent retinal detachment after traumatic retinal detachment surgery and analyze its clinical features.

Medical records of 77 patients (77 eyes) inpatients with recurrent retinal detachment from January 2013 to June 2018 in Beijing Tongren Eye Center were collected and retrospectively analyzed. Males 67 cases (67 eyes), females 10 cases (10 eyes), age 7 to 64 years-old, mean (35.0±14.5) years-old. The patients were divided into groups according to the cause of injury, time of recurrent retinal detachment, vitreous state and extent of retinal detachment. The distribution of age was described by mean±standard. The number and distributions in different groups were described by the number of eyes and percentage. Chi-square test was used to compare the proportion of patients with recurrent retinal detachment among different traumatic causes and differences of incidence in the retinal detachment with vitreous states.

Among all the patients, intraocular foreign body injury occurred recurrent retinal detachment were in 16 cases (16 eyes), accounting for 20.8%; closed eye trauma occurred recurrent retinal detachment were in 19 cases (19 eyes), accounting for 24.7%; open eye trauma except intraocular foreign body occurred recurrent retinal detachment were in 42 cases (42 eyes), accounting for 54.5%. According to chi-square test, comparison among three groups showed statistically significant differences (χ²=10.37, P<0.05); by after further comparison, there was a statistically significant difference between the closed eye trauma group or the open eye trauma group and the intraocular foreign body injury group (χ²=9.80, 7.01; P<0.05); there was a non-statistically significant difference between the closed eye trauma group and the open eye trauma group (χ²=0.90, P>0.05). Before recurrence of retinal detachment, the number of operations was 1 to 6 (mean 2.4±0.9) times. There were 44 cases (44 eyes), accounting for 57.1%, relapsed retinal detachment occurred within 3 months after the previous operation and 5 cases (5 eyes), accounting for 6.5%, relapsed retinal detachment occurred more than 12 months after the previous operation. Before this recurrent retinal detachment, there were 72 cases (72 eyes), accounting for 93.5%, underwent vitrectomy and 5 cases (5 eyes), accounting for 6.5%, underwent external scleral compression. 49 cases (49 eyes), accounting for 63.6% with silicone oil remained in the eye and 24 cases (24 eyes), accounting for 31.2%, were filled with aqueous humor. 34 cases (34 eyes), accounting for 44.2%, occurred inferior retinal detachment again and 26 cases (26 eyes), accounting for 33.8%, occurred whole retinal detachment again. Among patients with silicone oil-filled eyes, 13 cases (13 eyes), accounting for 26.5%, occurred whole retinal detachment and 27 cases (27 eyes), accounting for 55.1%, occurred inferior retinal detachment; 13 cases (13 eyes), accounting for 54.2%, occurred whole retinal detachment and 6 cases (6 eyes), accounting for 25.0%, occurred inferior retinal detachment. There was a statistically significant difference (χ²=5.37, 5.90; P<0.05). Among patients with silicone oil-filled eyes, 4 cases (4 eyes), accounting for 8.2%, occurred nasal retinal detachment; among patients with aqueous humor filling eyes, 1 case (1 eye), accounting for 4.2%, occurred nasal retinal detachment; among the patients without vitreous filling, 2 cases (2 eyes), accounting for 50.0%, occurred nasal retinal detachment. There was astatistically significant difference (χ²=8.85, P<0.05). 71 cases (71 eyes), accounting for 92.2%, had proliferative membranes in front of or under the retina. 74 cases (74 eyes) accounting for 9.1% underwent reoperation, of which, 71 cases (71 eyes), accounting for 96.0%, performed vitreous surgery and 67 cases (67 eyes), accounting for 94.4%, underwent silicone oil filling. The follow-up visits for 3 to 24 months after operation showed that 35 cases (35 eyes), accounting for 47.3%, had retinal reposition and among patients with silicone oil-filled eyes, 26 cases (26 eyes), accounting for 38.8%, refuse removing the silicone oil.

The main reason for traumatic recurrent retinal detachment is proliferative vitreoretinopathy. Vitrectomy combined with silicone oil filling is the main treatment, which has a poor prognosis.