Abstract
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Purpose: To evaluate the incidence of recurrent rhegmatogenous retinal detachment (RRD) following cataract surgery in eyes with prior RRD repair and to identify factors associated with recurrence.
Methods: This systematic review was prospectively registered with PROSPERO (CRD42025634266) and conducted in accordance with PRISMA guidelines. PubMed, Scopus, EMBASE, and CENTRAL were searched from inception through January 2025. Studies of adult patients reporting outcomes of cataract surgery in eyes with prior RRD repair were included. Two reviewers independently screened records and assessed risk of bias using the MINORS and STROBE checklists. Pooled incidence was estimated by proportion meta-analysis using an inverse variance model with logit transformation under random effects. A prespecified subgroup analysis stratified recurrence by prior repair technique: scleral buckle (SB), pars plana vitrectomy (PPV), and combined SB + PPV.
Results: Ten studies published between 1991 and 2024, including 1,485 eyes, were analyzed. The pooled incidence of recurrent RRD was 3% (95% CI, 2%–4%) with no heterogeneity (I² = 0%) and a prediction interval of 2% to 4%. Mean follow-up ranged from 11.5 to 149 months. Recurrence differed significantly by prior repair technique (P = .007), being highest after PPV (4.42%; 95% CI, 2.93%–6.62%), intermediate after SB (2.28%; 95% CI, 0.97%–5.27%), and lowest after combined SB + PPV (1.01%; 95% CI, 0.42%–2.39%). Postoperative visual acuity improved across all studies, with 70% to 74% of eyes achieving 20/40 or better. Posterior capsule opacification requiring YAG capsulotomy (22.5%) and cystoid macular edema (7.1%) were the most frequent complications, and no cases of endophthalmitis were reported. Risk factors for recurrence included younger age, high myopia, and posterior capsular rupture. No evidence of publication bias was detected (Egger test, P = .59).
Conclusions: Cataract surgery after RRD repair carries a low recurrence risk (3%) with favorable visual outcomes. Recurrence varies by RRD repair technique, with the highest rate after vitrectomy alone and the lowest after combined scleral buckle and vitrectomy. These findings support proceeding with cataract extraction when clinically indicated, with close follow-up of high-risk eyes during the first 6 to 12 months.
Keywords: retinal detachment; cataract surgery; phacoemulsification; recurrence; meta-analysis
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