Comparison study of results of vitrectomy and vitrectomy with scleral buckling for the treatment of patients with rhegmatogenous retinal detachment at high risk proliferative vitreoretinopathy

Abstract Purpose: To demonstrate combined local dry vitrectomy and segmental scleral buckling for the treatment of partial rhegmatogenous retinal detachment (RRD) with local vitreous traction in patients at high-risk for proliferative vitreoretinopathy (PVR). Methods: Seven eyes of 7 patients were retrospectively studied, including 3 retinal dialysis, 3 retinal detachment (RD) with peripheral retinal holes and 1 RD with giant tear. All patients exhibited local vitreous traction and a high risk for PVR. Dry local vitrectomy without regular infusion was performed to remove the vitreous traction. Viscoelastic fluid was injected into the vitreous cavity if needed. Segmental scleral buckling was performed accordingly. Demographic information, preoperative and postoperative complications, and outcomes were recorded. Results: The mean age of the patients at presentation was 22.43±14.28 years old. All seven patients obtained retinal reattachment after a single surgical intervention. Postoperative visual acuity was improved in all patients. None of them developed complications, except for temporary mildly increased intraocular pressure in 2 cases. Conclusions: Combined local dry vitrectomy and segmental scleral buckling is effective for patients of RRD with local vitreous traction. The technique avoids many complications associated with regular surgery and was minimally invasive to both the external and internal eye.

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Using Surgical Microscope for Sclera Buckling and Transscleral Cryopexy: An Alternative Procedure of Treatment for Rhegmatogenous Retinal Detachment

BioMed Research International ◽

10.1155/2014/364961 ◽

2014 ◽

Vol 2014 ◽

pp. 1-7

Author(s):

Liu-xue-ying Zhong ◽

Yi Du ◽

Wen Liu ◽

Su-Ying Huang ◽

Shao-chong Zhang

Keyword(s):

Retinal Detachment ◽

Proliferative Vitreoretinopathy ◽

Rhegmatogenous Retinal Detachment ◽

Scleral Buckling ◽

Surgical Microscope ◽

Initial Surgery ◽

Retinal Breaks ◽

Retinal Reattachment ◽

Indirect Ophthalmoscope

Purpose.To observe the long-term effectiveness of scleral buckling and transscleral cryopexy conducted under a surgical microscope in the treatment of uncomplicated rhegmatogenous retinal detachment.Methods.This was a retrospective analysis in a total of 227 consecutive patients (244 eyes) with uncomplicated rhegmatogenous retinal detachment (proliferative vitreoretinopathy ≤ C2). All patients underwent scleral buckling and transscleral cryopexy under a surgical microscope without using a binocular indirect ophthalmoscope or a contact lens.Results.After initial surgery, complete retinal reattachment was achieved in 226 eyes (92.6%), and retinal redetachment developed in 18 eyes (7.4%). The causes of retinal redetachment included presence of new breaks in eight eyes (44%), failure to completely seal the breaks in five eyes (28%), missed retinal breaks in four eyes (22%), and iatrogenic retinal breaks in one eye (6%). Scleral buckling surgery was performed again in 12 eyes (66%). Four eyes (22%) developed proliferative vitreoretinopathy and then were treated by vitrectomy. The sealing of retinal breaks and complete retinal reattachment were achieved in 241 eyes (98.8%).Conclusion.Probably because of clear visualization of retinal breaks and being controllable under a surgical microscope, the microsurgery of scleral buckling and transscleral cryopexy for uncomplicated retinal detachment exhibits advisable effectiveness.

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