Grosinger AJ, Nicholson BP, Shah SM, et al. - In this retrospective cohort study, researchers sought to evaluate the incidence of unplanned return to the operating room (ROR) at ≤ 45 days or ≥ 46 days after primary retinal detachment (RD) surgery and correlate ROR with preoperative risk factors and visual outcomes. A retrospective review of patients with primary retinal detachment surgery to evaluate for unplanned ROR between January 1, 2012, and June 30, 2014, with follow-up of 90 days to 8 years (mean of 1.5 years). Between January 1, 2012, and June 30, 2014, 268 patients receiving 270 primary rhegmatogenous retinal detachment surgeries. Considering that only 51.5% of all RORs occurred within 45 days, a previously used 45-day ROR surgical quality metric may be of limited use for retinal detachment surgery. Factors like age at presentation, number of retinal breaks, number of detached clock hours, use of silicone oil tamponade for pars plana vitrectomy (PPV), history of choroidal detachment, high myopia, ocular trauma, and open globe were correlated with increased risk of ROR. A more precise and useful quality assurance measure for measuring the quality of surgical care in vitreoretinal surgery can be provided by incorporating risk-adjusted metrics.