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Presentation type	Oral presentation
Title	Determinants of anatomical and functional outcomes after surgery for rhegmatogenous retinal detachment: a 10-year tertiary-center cohort study

Purpose	To identify factors independently associated with primary anatomical failure after rhegmatogenous retinal detachment (RRD) surgery, and to compare them with those associated with visual outcome.
Methods	Retrospective cohort of consecutive adults operated for primary RRD at HUB Erasme, ULB (2015–2025). The primary outcome was anatomical success at 3 months. In the vitrectomy sub-cohort with 3-month follow-up (n = 320), anatomical failure and 3-month best-corrected visual acuity (BCVA, logMAR) were analyzed by multivariable logistic and linear regression using prespecified covariates.
Results	We included 443 eyes of 425 patients (mean age 59.7 years, 52.8% macula-off). Primary anatomical success was 93.7% at 1 month and 85.9% at 3 months; final success 98.6%. Mean BCVA improved from 0.87 to 0.25 logMAR. Anatomical failure was independently associated with preoperative proliferative vitreoretinopathy (PVR; aOR 5.16, 95% CI 2.13–12.50, p < 0.001) and four-quadrant detachment (3.70, 1.64–8.36, p = 0.002). Worse 3-month BCVA was independently associated with four-quadrant detachment (adjusted β +0.23 logMAR, 0.07–0.39, p = 0.006), primary anatomical failure (+0.34, 0.15–0.53, p < 0.001), ocular comorbidity (+0.17, 0.04–0.29, p = 0.008) and macula-off status (+0.10, 0.02–0.19, p = 0.016), but not PVR (p = 0.089); without anatomical failure, PVR was associated with worse BCVA (+0.31, p = 0.012).
Conclusion	Anatomical and functional prognostic factors were only partly shared: the visual cost of preoperative PVR was consistent with mediation by anatomical failure, macula-off status was associated with visual outcome independently of the anatomical result, and four-quadrant detachment with both.
Conflict of interest	No

Authors 1

Last name	BARAKAT
Initials	S
Department	HUB Erasme (ULB)
City	Brussels

Authors 2

Last name	LIPSKI
Initials	D
Department	HUB Erasme (ULB)
City	Brussels

Authors 3

Last name	MOTULSKY
Initials	E
Department	HUB Erasme (ULB)
City	Brussels