Six-months primary success rate for retinal detachment between vitrectomy and scleral buckling

Purpose: There are primarily two techniques for affixing the scleral buckle (SB) to the sclera in the repair of rhegmatogenous retinal detachment (RRD): scleral tunnels or scleral sutures. Methods: This retrospective study examined all patients with primary RRD who were treated with primary SB or SB combined with vitrectomy from January 1, 2015 through December 31, 2015 across six sites. Two cohorts were examined: SB affixed using scleral sutures versus scleral tunnels. Pre- and postoperative variables were evaluated including visual acuity, anatomic success, and postoperative strabismus. Results: The mean preoperative logMAR VA for the belt loop cohort was 1.05 ± 1.06 (Snellen 20/224) and for the scleral suture cohort was 1.03 ± 1.04 (Snellen 20/214, p = 0.846). The respective mean postoperative logMAR VAs were 0.45 ± 0.55 (Snellen 20/56) and 0.46 ± 0.59 (Snellen 20/58, p = 0.574). The single surgery success rate for the tunnel cohort was 87.3% versus 88.6% for the suture cohort (p = 0.601). Three patients (1.0%) in the scleral tunnel cohort developed postoperative strabismus, but only one patient (0.1%) in the suture cohort (p = 0.04, multivariate p = 0.76). All cases of strabismus occurred in eyes that underwent SB combined with PPV (p = 0.02). There were no differences in vision, anatomic success, or strabismus between scleral tunnels versus scleral sutures in eyes that underwent primary SB. Conclusion: Scleral tunnels and scleral sutures had similar postoperative outcomes. Combined PPV/SB in eyes with scleral tunnels might be a risk for strabismus post retinal detachment surgery.

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Anatomical and functional outcomes of surgery of rhegmatogenous retinal detachment

Nepalese Journal of Ophthalmology ◽

10.3126/nepjoph.v2i2.3720 ◽

1970 ◽

Vol 2 (2) ◽

pp. 132-137 ◽

Cited By ~ 1

Author(s):

H Sharma ◽

SN Joshi ◽

JK Shrestha

Keyword(s):

Visual Acuity ◽

Retinal Detachment ◽

Success Rate ◽

Pars Plana Vitrectomy ◽

Rhegmatogenous Retinal Detachment ◽

Case Series ◽

Scleral Buckling ◽

Pars Plana ◽

A Prospective Study ◽

Physiological Outcome

Introduction: Rhegmatogenous retinal detachment (RRD) is a potentially blinding condition. Objective: To evaluate the anatomical and functional outcome of surgery of RRD. Materials and methods: A prospective study of interventional case series was designed including 50 consecutive patients with RRD in a tertiary level eye center in Kathmandu. The patients underwent scleral buckling (SB) or pars plana vitrectomy (PPV) according to the proliferative vitreo-retinopathy (PVR) changes. All the patients had at least 3 months of follow-up. The anatomical and physiological outcome measures were primary retinal reattachment and improvement in visual acuity respectively. The surgery was considered successful when there was attachment of retina after the first surgery. Results: The mean age of these patients at the time of presentation was 46.24 ± 19.82 years. Of 50, sixty-six percent of the patients underwent SB and 34 % underwent PPV. Primary surgical success rate was 88 %. While comparing the initial best corrected visual acuity (BCVA) with the final, 72% had an improvement, 12 % unchanged and 16 % had a deteriorated visual acuity. Conclusion: The visual acuity improves and the anatomical success rate is high in the majority of the patients after surgery for rhegmatogenous retinal detachment. Keywords: rhegmatogenous retinal detachment; scleral buckling; pars plana vitrectomy; anatomical outcome; physiological outcome DOI: 10.3126/nepjoph.v2i2.3720 Nep J Oph 2010;2(2) 132-137

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Long-term Clinical Results of Vitrectomy and Scleral Buckling in Treatment of Rhegmatogenous Retinal Detachment

The Scientific World JOURNAL ◽

10.1155/2019/5416806 ◽

2019 ◽

Vol 2019 ◽

pp. 1-7 ◽

Cited By ~ 3

Author(s):

I. Schmidt ◽

N. Plange ◽

G. Rößler ◽

H. Schellhase ◽

A. Koutsonas ◽

...

Keyword(s):

Retinal Detachment ◽

Success Rate ◽

Rhegmatogenous Retinal Detachment ◽

Case Series ◽

Clinical Results ◽

Scleral Buckling ◽

Long Term Results ◽

Encircling Band

Purpose. Most studies about retinal detachment cover a limited follow-up period. The purpose of this research is to assess the long-term results after pars plana vitrectomy (PPV) and scleral buckle (SB) surgery in patients with rhegmatogenous retinal detachment (RRD). Methods. 155 patients with RRD are treated either with SB or PPV with a mean follow-up of more than 5 years. Retrospective analysis of patient data with RRD was performed between January 2006 and June 2008 at a tertiary eye clinic. Results. Overall primary success rate was 85.2% (PPV: 84.6%, SB: 89.5%; p=0.57). 90.5% of redetachments appeared within the first 124 days. No significant different success rate was found for vitrectomy with and without additional encircling band (p=0.09). No advantage of a supplemental encircling band in cases of preoperative inferior breaks was seen (p=0.81). Patients of SB group were treated more frequently in follow-up time because of epiretinal membrane (ERM) (SB: 15.5% versus PPV: 7.3%). No patient of the PPV group without intraoperative use of endolaser cerclage (14.7%) had any peeling surgery postoperatively. Conclusion. Redetachment rates of both methods are comparable in a clinical setting where PPV is considered a suitable method for pseudophakic patients and in complex cases and SB was performed in younger phakic patients with clearly identified retinal tears. PPV seems to show a more heterogenous pattern of complications. No advantage of a supplemental encircling band could be found in these case series of patients with primary RRD. No relevant long-term risk of redetachment was seen after SB.

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The learning curve of retinal detachment surgery

Graefe s Archive for Clinical and Experimental Ophthalmology ◽

10.1007/s00417-021-05096-1 ◽

2021 ◽

Author(s):

Viola Radeck ◽

Horst Helbig ◽

Teresa Barth ◽

Maria-Andreea Gamulescu ◽

David Maerker ◽

...

Keyword(s):

Retinal Detachment ◽

Learning Curve ◽

Success Rate ◽

Learning Curves ◽

Successful Outcome ◽

Success Rates ◽

Retinal Detachment Surgery ◽

Primary Success ◽

Female Surgeons ◽

The Individual

Abstract Purpose To investigate the learning curve of vitreoretinal (VR) surgeons beginning training in retinal detachment (RD) surgery. Methods The files of all consecutive patients undergoing VR surgery for uncomplicated RD between Jan 2005 und Mar 2020 were retrospectively reviewed. Successful outcome was defined as no retinal redetachment within 3 months after surgery. Results Ten surgeons started their VR career during this period. Together, these 10 surgeons performed 3786 RD operations (mean 379; median 251; range 71–1053). Primary success rate after one operation was 90% (3420 of 3786). When starting to operate retinal detachments, VR surgeons had a primary success rate of about 80%. Redetachment rates steadily decreased and stabilized at just under 10% after about 200 operations. Beginners needed more than twice the time for the procedure compared to experienced surgeons. The individual learning curves varied widely. In our series, female surgeons seem to have a faster learning curve. Conclusion RD surgery performed by VR surgeons in training had acceptable results. With increasing experience, success rates continuously improve reaching stable levels after approximately 200 operations. The training of VR surgeons requires considerable resources.

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Anatomic and Visual Outcomes of Scleral Buckling Versus Primary Vitrectomy in Pseudophakic and Aphakic Retinal Detachment: Six-Month Follow-up Results of a Single Operation—Report No. 1

Yearbook of Ophthalmology ◽

10.1016/s0084-392x(08)70319-8 ◽

2006 ◽

Vol 2006 ◽

pp. 137-138

Author(s):

J.F. Vander

Keyword(s):

Retinal Detachment ◽

Scleral Buckling ◽

Primary Vitrectomy ◽

Visual Outcomes ◽

Single Operation ◽

Aphakic Retinal Detachment

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Long-term visual recovery after scleral buckling procedure of rhegmatogenous retinal detachment involving the macula

Korean Journal of Ophthalmology ◽

10.3341/kjo.2000.14.1.20 ◽

2000 ◽

Vol 14 (1) ◽

pp. 20 ◽

Cited By ~ 8

Author(s):

S D Chang ◽

I T Kim

Keyword(s):

Retinal Detachment ◽

Rhegmatogenous Retinal Detachment ◽

Scleral Buckling ◽

Visual Recovery ◽

Scleral Buckling Procedure

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Biomedical Materials to Repair Retinal Detachments

MRS Proceedings ◽

10.1557/proc-55-55 ◽

1985 ◽

Vol 55 ◽

Author(s):

Miguel F. Refojo

Keyword(s):

Retinal Detachment ◽

Silicone Rubber ◽

Methyl Acrylate ◽

Silicone Oil ◽

Vitreous Body ◽

Light Sensitivity ◽

Scleral Buckling ◽

Intraocular Injection ◽

Other Substances

ABSTRACTImplants are essential for the repair of retinal detachments. The implant buckles the wall of the eye and apposes the detached retina with the choroid, thus restoring light sensitivity to the retina. The scleral buckling also relieves traction on the retina from a shrinking vitreous body. The implant materials most commonly used are solid silicone rubber and silicone sponges, but both types have some disadvantages. A poly(hydroxyethyl acrylate-co-methyl acrylate) hydrogel implant with improved properties of softness and antibiotic absorption is also available for retinal detachment surgery. Proliferative vitreoretinopathy involves various conditions of retinal detachment complicated by vitreous fibrosis, which, after vitrectomy, may be treated with intraocular injection of fluids that support the retina against the choroid. For conditions requiring a long-term implant, silicone oil although controversial is the material of choice. Many other substances have been investigated but none better has yet been found.

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