Just wondering, Dr. Hagan, roughly how many patients you've had who have come to you with recurrent detachments after 1 or more years of complete attachment?
Online studies I'm seeing seem to give quite a wide range of percentages. Despite reading them in detail, I'm not always sure how they're carried out - do you just take note of all detachments you operate on during a particular period and say what percentage were late recurrences (possibly originally operated on by someone else), or do you follow up patients having operated on them for primary detachment and see how many get a late recurrence? Most of these studies seem to have only a 10-year running time and I'm imagining if the second method is used, the percentages they end up with may be rather on the low side for lifetime estimates.
Also the commonly quoted 15%-or-so risk to the fellow eye (is that lifetime risk? I'm also thinking probably a bit higher than this for aphakes like me) doesn't seem to take account of whether the fellow eye has already had a PVD. I did see one study on aphakes - admittedly a rather old one - that took account of PVD and found a ten-fold reduction in rate of detachment in the fellow eye if PVD was already complete - but no idea over what time period this ran. You can't follow people up indefinitely of course! (And ascertaining completeness of PVD can be tricky too).
Also, if the primary detachment was precipitated by PVD, would it not be likely that if the fellow eye was going to detach, it would usually (but not always) do so within a few years, since PVDs are quite often only a few years apart?
You will know all the studies (and many more) much better than I do, of course.
What I'm kind of getting round to saying is that I know RD patients are never out of the woods in either eye for the rest of their lives, but is the risk likely to be uniform throughout that time? Some of the studies seem to quote x% yearly risk, and I'm just wondering how useful that really is. I imagine it will also depend a fair bit too on cause of original detachment, as well as other predisposing factors. For late recurrences in the operated eye they seem to talk about contraction of residual vitreous around the vitreous base, which (as a non-medic) sounds to me like something that could randomly happen at any time to anyone, no matter how far from surgery it took place.
Not asking for odds in my particular case as my surgeon will be able to give more of an idea on that, but at the moment working with trying to come to terms with something like 20% lifetime risk to both eyes.