PERSISTENT LOCULATED SUBRETINAL FLUID AFTER RHEGMATOGENOUS RETINAL DETACHMENT SURGERY MICHAEL MIMOUNI, MD,* TAREQ JAOUNI, MD,† MOR BEN-YAIR, MD,* SHIRAN ALMUS, MD,* LAURA DERMAN, MD,* SCOTT EHRENBERG, BSCMED,* DIEGO ALMEIDA, MD,† YOREH BARAK, MD,* SHIRI ZAYIT-SOUDRY, MD,* EDWARD AVERBUKH, MD† Purpose: To identify factors associated with persistent subretinal fluid (SRF) after small- gauge pars plana vitrectomy for primary rhegmatogenous retinal detachment. Methods: This retrospective study included patients from 2 tertiary centers who underwent pars plana vitrectomy for repair of rhegmatogenous retinal detachment between 2013 and 2016. Preoperative and intraoperative parameters were examined for association with development of SRF. Results: Overall, 153 eyes of 153 patients, mean age of 55.2 ± 17.9 years were included. Persistent SRF occurred in 15.0% (n = 23) and was associated with high myopia (65.22 vs. 26.15%, P , 0.001), macula-involving retinal detachment (91.30 vs. 66.15%, P = 0.02), phakic lens status (86.96 vs. 66.15%, P = 0.04), and younger age (47.8 ± 18.7 vs. 56.5 ± 17.5, P = 0.04) while drainage retinotomy was protective (13.04 vs. 34.11%, P = 0.04). In multivariate analysis, high myopia (P = 0.009) and macula-involving retinal detachment (P = 0.004) were associated with SRF, while drainage retinotomy was protective (P = 0.03). Persistent SRF was associated with outer retinal band irregularity (30.4 vs. 9.3%, P = 0.005). There were no significant differences in terms of change in best-corrected visual acuity from presentation (P = 0.70), or final best-corrected visual acuity (P = 0.54). Conclusion: Eyes with preoperative high myopia and macular involvement, and those in which a drainage retinotomy was not performed, were more likely to develop persistent SRF. RETINA 00:1–7, 2019 P ersistent subretinal fluid (SRF), noted as focal microscopic loculations of fluid trapped under the retina even when gross retinal reattachment is seen, has been reported to occur in more than 50% of patients treated for rhegmatogenous retinal detachment (RRD) with scleral buckling (SB) 1,2 and in 0% to 15% treated with primary pars plana vitrectomy (PPV). 3,4 The higher rate of persistent SRF after SB can be explained by the fact that without a PPV, not all the fluid is drained intraoperatively, and gradual SRF resorption may typically be noted postoperatively, potentially accounting for a higher likelihood of trapped loculated fluid. It is unclear whether or not persistent loculated SRF is associated with worse visual outcomes as con- flicting results have been reported. 3–6 To date, the main factor associated with the persistence of postop- erative loculated SRF is younger patient age. 7 A paucity of data exists regarding persistent locu- lated SRF after PPV with or without SB for the treatment of primary RRD. Therefore, the purpose of this study was to assess the incidence, associated factors, and outcomes of patients with persistent loculated SRF in this entity. Materials and Methods This retrospective cohort study was conducted in accordance with the Declaration of Helsinki. All From the *Department of Ophthalmology, Rambam Health Care Campus, Technion—Israel Institute of Technology, Haifa, Israel; and †Department of Ophthalmology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel. None of the authors has any financial/conflicting interests to disclose. M. Mimouni, T. Jaouni, S. Zayit-Soudry, and E. Averbukh con- tributed equally to this paper. Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s Web site (www.retinajournal.com). Reprint requests: Michael Mimouni, MD, Department of Ophthalmology, Rambam Health Care Campus, P.O.B. 9602, Haifa, Israel 31096; e-mail: michael@intername.co.il 1 Copyright © by Ophthalmic Communications Society, Inc. Unauthorized reproduction of this article is prohibited.