Anatomical and Functional Outcomes of Scleral Buckling for Rhegmatogenous Retinal Detachment Surgeries.

Abstract

Purpose: The aim of the study is to analyze the anatomical and functional outcomes of scleral buckling surgeries for non-complicated rhegmatogenous retinal detachment surgeries.
Materials and Methods: This was a retrospective analysis 2602 cases that underwent scleral buckling for the repair of rhegmatogenous retinal detachments. The study was conducted at the ophthalmology department of Lahore General Hospital from 2003 to 2015. Pre-operatively patients were assessed and data collected for age, refractive error, the status of the intraocular lens, proliferative vitreoretinopathy, number and morphology of breaks, type of buckling procedure. Post-operatively best-corrected visual acuity and reattachment rates were observed.
Results: A total of 2602 patients with primary rhegmatogenous retinal detachment who underwent scleral buckling repair were included in the study. The mean age was 30.2 ± 15.6 years (range 3 - 69). 73% of patients were pseudophakic, 17% were aphakic and 10% were phakic. Myopic refractive error less than 6 diopters were present in 75% patients and 25% had more than 6 diopters. Out of 73% of pseudophakia patients, 341 ± 114.6 patients had eventful cataract surgery done before the procedures with a posterior capsular defect. Majority of patients 878 ± 46.7 had proliferative vitreoretinopathy grade B. 65% of patients had a single break. In terms of anatomical location 271 ± 87.3 had superior breaks, 197 ± 63.4 had temporal breaks, 137 ± 51.2 had inferior breaks and 64 ± 13.2 had nasal breaks. Morphologically the majority had a horseshoe-shaped break. In terms of buckling procedures, 58% of patients underwent segmental buckle, 12% underwent complete encirclement and 30% had a combined procedure. 397 eyes had to undergo a redo surgery, pars plana vitrectomy with oil. Best corrected visual acuity ranging from finger counting to 6/9 on Snellens was achieved by 89% of the treated eyes.
Conclusion: Primary rhegmatogenous retinal detachment surgery utilizing scleral buckling operation achieves high anatomical and functional success rates.  

Keywords

• rhegmatogenous retinal detachment
• pars planna vitrectomy
• scleral buckling

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