Outcomes of primary vitrectomy versus scleral buckling in the treatment of uncomplicated rhegmatogenous retinal detachment

Abstract

The aim of the study is to compare the outcomes of pars plana vitrectomy (PPV) and conventional scleral buckling (SB) surgeries for the treatment of uncomplicated rhegmatogenous retinal detachment (RRD). This is a retrospective, comparative study. The charts of patients who underwent PPV or SB for RRD repair at a single institution between January 2013 and December 2022 were reviewed. Baseline demographics, previous ocular history, findings of ocular examination, surgical data and complications were recorded. The patients were divided into two groups as PPV (n =112) and SB (n =57) according to the surgical procedure they underwent. The primary outcome parameter is the re-attachment rate. Secondary outcome parameters are visual acuity (VA), the rates of re-detachment and complications, and total number of surgeries. Anatomical re-attachment rate by single surgery was 91.1% in the PPV group and 78.9% in the SB group (p =0.027). The rates of re-detachment (5.4% vs 14%, p =0.053) and secondary PVR (8.9% vs 8.8%, p =0.973) were similar in PPV and SB groups. The total number of surgeries was also similar in both groups (p =0.204). The final median VA was similar in PPV and SB groups (0.7 vs 0.5 LogMAR, p =0.072), and significantly increased postoperatively (p <0.001). Secondary glaucoma developed in 8 (7.1%) and 4 (7.0%) eyes in the PPV and SB groups, respectively (p =0.976). Pre-operative VA (p= 0.044, B= -0.516, 95% CI: 0.361-0.987) and operation time (p= 0.001, B= -0.029, 95% CI: 0.955-0.989) were found to be predictors of the primary outcome. In the treatment of RRD, PPV has a higher rate of anatomic success than SB. Final VA was similar with both surgical methods. Pre-operative good VA and early operation time are predictors of the good anatomical outcome.

Keywords

• pars plana vitrectomy
• retinal detachment
• rhegmatogenous retinal detachment
• scleral buckling
• vitrectomy

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