Surgical Outcomes of Progressive Retinoschisis-Related Retinal Detachments: A 17-Year Survey from a Large Academic Center

BACKGROUND AND OBJECTIVE: To provide an overview of progressive retinoschisis-related retinal detachment (RSRD) management at a tertiary referral center. MATERIALS AND METHODS: Single-institution retrospective case series from January 1, 2003, to May 1, 2020. RESULTS: Progressive RSRD occurred in 0.9% of patients with retinoschisis. Mean (range) age at time of surgery was 58.7 years (40.0 to 74.0). Ten eyes were initially treated with scleral buckle, three eyes with vitrectomy, and three eyes with combined scleral buckle and vitrectomy. Overall reattachment rate was 100.0%; single-surgery success was 56.2%. Proliferative vitreoretinopathy developed in 10.0% of scleral buckles, 33.3% of vitrectomies, and 33.3% of combined surgeries. CONCLUSIONS: Progressive RSRD is rare and poses surgical management challenges. Final retinal attachment can be achieved successfully but often requires secondary and staged surgeries. Localization of outer retinal breaks may help guide surgical management. Further research—such as a large-scale, prospective, multicenter, randomized trial—would be needed to determine the optimal surgical technique.