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Eliott, Dean MD*,†; Stryjewski, Tomasz P. MD, MPP*,†; Andreoli, Michael T. MD; Andreoli, Christopher M. MD*,‡,§

doi: 10.1097/IAE.0000000000001361
Original Study

Purpose: To determine the incidence of retinal redetachment due to proliferative vitreoretinopathy after open-globe trauma in smokers and nonsmokers.

Methods: A total of 892 patients comprising 893 open-globe injuries, in whom 255 eyes were diagnosed with a retinal detachment, and 138 underwent surgical repair were analyzed in a retrospective case–control study. Time to redetachment was examined using the Kaplan–Meier method and analysis of risk factors was analyzed using Cox proportional hazards modeling.

Results: Within one year after retinal detachment surgery, 47% (95% CI, 39–56%) of all 138 repaired retinas redetached because of proliferative vitreoretinopathy. Being a smoker was associated with a higher rate of detachment (adjusted hazard ratio 1.96, P = 0.01). As shown in previous studies, the presence of proliferative vitreoretinopathy at the time of surgery was also an independent risk factor for failure (adjusted hazard ratio 2.13, P = 0.005). Treatment with vitrectomy-buckle compared favorably to vitrectomy alone (adjusted hazard ratio 0.58, P = 0.04). Only 8% of eyes that redetached achieved a best-corrected visual acuity of 20/200 or better, in comparison to 44% of eyes that did not redetach (P < 0.001).

Conclusion: Proliferative vitreoretinopathy is a common complication after the repair of retinal detachment associated with open-globe trauma, and being a smoker is a risk factor for redetachment. Further study is needed to understand the pathophysiologic mechanisms underlying this correlation.

In patients with an open-globe injury who developed a retinal detachment, 47% of these patients redetached postoperatively because of proliferative vitreoretinopathy. Current smokers had nearly twice the rate of redetachment in comparison to nonsmokers.

*Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts;

Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts;

Department of Ophthalmology, The University of Illinois at Chicago, Chicago, Illinois; and

§Harvard Vanguard Medical Associates, Boston, Massachusetts.

Reprint requests: Dean Eliott, MD, Department of Ophthalmology, Harvard Medical School, Massachusetts Eye and Ear Infirmary, 243 Charles Street, Boston, MA 02114; e-mail:

None of the authors has any financial/conflicting interests to disclose.

D. Eliott and T. P. Stryjewski are co-first authors.

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© 2017 by Ophthalmic Communications Society, Inc.