scholarly journals Outcome of Scleral Buckling Surgery in Rhegmatogenous Retinal Detachment

1970 ◽  
Vol 6 (1) ◽  
pp. 21-24
Author(s):  
MI Hossain ◽  
MK Hasan ◽  
MSM Ali

A longitudinal study was carried out in the vitreo-retina clinic of the National Institute of Ophthalmology andHospital (NIO&H) on 30 eyes of 25 patients who were treated with scleral buckle (SB) surgery during theperiod of October 2004 to September 2005 of either sex. The aim of this study was to determine the outcome ofSB surgery in Rhegmatogenous retinal detachment (RRD). The main entry criteria for this study wereprimary RRD treated with SB and for which 12 weeks of follow-up were available. The eyes with proliferativevitreoretinopathy or with history of SB surgery, vitrectomy, posterior segment open-globe trauma orsignificant concurrent eye disease e.g. amblyopia, macular disease etc were excluded from this study. Overalltwenty-four eyes (80%) achieved retinal reattachment with one SB procedure (encircling or segmental); themedian 12-week visual acuity was 6/12. Three additional eyes (10%) achieved retinal reattachment with onevitreoretinal procedure; the median 12-week visual acuity was 6/9. Three eyes (10%) never achieved retinalreattachment despite one additional vitreoretinal procedure, and 12-week visual acuity was no perception oflight. It can be concluded that SB for primary RRD achieves anatomical efficacy and preservation of centralvision in the majority of eyes.Key words: Scleral buckle; Rhegmatogenous retinal detachment outcome.DOI: 10.3329/jafmc.v6i1.5987Journal of Armed Forces Medical College, Bangladesh Vol.6(1) 2010 p.21-24

Author(s):  
Matthew R. Starr ◽  
Edwin H. Ryan ◽  
Anthony Obeid ◽  
Claire Ryan ◽  
Xinxiao Gao ◽  
...  

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.


2021 ◽  
pp. 112067212110640
Author(s):  
Yehonatan Weinberger ◽  
Amir Sternfeld ◽  
Natalie Hadar-Cohen ◽  
Matthew T.S. Tennant ◽  
Assaf Dotan

Purpose To evaluate the outcomes and complications of scleral buckle surgery alone or combined with pneumatic retinopexy (pneumatic buckle) for the treatment of primary rhegmatogenous retinal detachment. Design Retrospective chart review. Participants Two hundred thirteen patients with rhegmatogenous retinal detachment of whom 101 underwent primary scleral buckle surgery at Rabin Medical Center in 2005–2015 (SB group) and 112 underwent pneumatic buckle surgery at Royal Alexandra Hospital in 2013–2015 (PB group). Methods All patients were followed for ≥12 months. Data on clinical and surgical parameters, outcome, and complications were collected from the medical files. Main Outcome Measures Best corrected visual acuity and anatomical outcomes. Results At 12 months, average best corrected visual acuity was 0.3 logMar in the SB group and 0.42 logMar in the PB group ( P < 0.05). Rates of anatomical reattachment were high and similar in the two groups (99% and 97%, respectively, P = 0.623). The SB group had a higher percentage of patients requiring additional laser applications (21% vs. 7%; P < 0.01) and buckle readjustment surgery (6% vs. 0; P = 0.01), and the PB group had a higher percentage of patients who required postoperative pars plana vitrectomy (30% vs. 17%; P = 0.03). Conclusion Scleral buckle surgery alone is efficient for the treatment of rhegmatogenous retinal detachment. Its combination with pneumatic retinopexy usually has no significant added value in terms of anatomical reattachment rate. Outcomes of Pneumatic buckling vs Scleral Buckling for RRD


2018 ◽  
Vol 2018 ◽  
pp. 1-4
Author(s):  
Ritesh Shah ◽  
Raghunandan Byanju ◽  
Sangita Pradhan ◽  
Sudha Ranabhat

Introduction. Scleral buckle surgery retains a special place in treatment of retinal detachment despite development of new and advanced vitreoretinal surgical techniques. The outcome of any retinal detachment surgery depends on correct selection of patient, type and nature of detachment, and the expertise. This study aims to evaluate various other parameters that determine the outcome of scleral buckle surgery. Method. Records of 55 patients with primary rhegmatogenous retinal detachment treated with scleral buckling over a duration of 18 months that had a minimum of 3-month follow-up were retrospectively reviewed. Preoperative and postoperative characteristics were recorded. Parameters that were evaluated to determine the outcome were best-corrected visual acuity (BCVA), anatomical success, and complications. Results. A total of 51 eyes of 50 patients that met the inclusion criteria were included. Mean age was 41 ± 19.9 years (range: 9 to 83). Primary anatomical success was achieved in 80.4%. Parameters significantly associated with the anatomical outcome of surgery were status of lens, preoperative visual acuity, and extent of retinal detachment. There was a significant improvement of visual acuity postoperatively. Conclusion. Scleral buckle surgery is a highly effective surgery in uncomplicated retinal detachment cases, and single surgery success rates are better in cases with good preoperative visual acuity, partial detachment, and clear crystalline lens.


Supplemental scleral buckling techniques in vitrectomy for the repair of rhegmatogenous retinal detachment to achieve higher reattachment rates are not widely used but may be useful especially in complicated cases. In this article, the positive and negative aspects of adding scleral buckle to primary vitrectomy will be examined by looking at relevant studies.


2019 ◽  
Vol 4 (4) ◽  
pp. 61-65
Author(s):  
D. G. Arsiutov

Background. The method of the use of autologous conditioned platelet rich plasma is a promising method in the surgery of retinal pathology, particularly in the surgery of rhegmatogenous retinal detachment without the use of additional endolaser photocoagulation, but requires the foundation of its efficiency.Aim: to evaluate the effectiveness of the surgery of rhegmatogenous retinal detachment with central (macular) and peripheral retinal tears, including retinal abruption from the dentate line, with the use of 25, 27-gauge subtotal vitrectomy, pneumoretinopexy and silicone oil tamponade with blocking of retinal defect with the use of autologous conditioned plasma without the use of endolaser photocoagulation around retinal defects.Materials and methods. The surgery included 25, 27-gauge vitrectomy, posterior hyaloid membrane removal, internal limiting membrane removal in case of macular hole, pneumoretinopexy, instiilation in 2–3 layers of autologous conditioned platelet rich plasma, devoid of leukocytes and containing 1.5–3 times more thrombocytes than in whole blood into the area of retinal detachment or along the edge of retinotomy till the retinal defect and nearby intact retina are totally covered. A total of 29 patients with visual acuity from 0.03 to 1.0 underwent the surgery.Results. In the early postoperative period (up to 1 month) 96.6 % of patients showed total retinal reattachment, retinal detachment was blocked, in one patient with multiple retinal tears recurrent retinal detachment was detected; in the early delayed postoperative period (1–3 months) 82.8 % of patients showed total retinal reattachment, in 5 patient retinal reattachment was partial.In the late postoperative period (4–12 months) 86.2 % of patients showed total retinal reattachment, there were 4 recurrent retinal detachments. Patients with recurrent retinal detachment were successfully reoperated. Autologous conditioned plasma was not used during reoperations. Visual acuity of the patients, which underwent surgery in the late postoperative period, was 0.1–1.0.Conclusions. 25, 27-gauge vitreoretinal surgery of rhegmatogenous retinal detachment with central and peripheral retinal tears, including tears with abruption from the dentate line and retinal defects blocking with the use of autologous conditioned plasma rich with thrombocytes without the use of endolaser photocoagulation around retinal defects – is a method which allows to achieve in most cases total retinal reattachment, better functioning of the operated eye.


1970 ◽  
Vol 2 (2) ◽  
pp. 132-137 ◽  
Author(s):  
H Sharma ◽  
SN Joshi ◽  
JK Shrestha

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


2014 ◽  
Vol 695 ◽  
pp. 544-547
Author(s):  
Zuhaila Ismail ◽  
Alistair Fitt ◽  
Colin Please

Scleral buckling is a surgical technique to treat rhegmatogenous retinal detachment (RRD). Vision may be affected by the scleral buckle. Since the buckle is pushed into the sclera towards the detached retina, it may change the shape and the focal length of the eyeball. A paradigm mathematical model of human eyeball is set up to examine how the focal length of the eye is affected under the action of the external force. In particular, this model has been developed using the membrane equations of equilibrium for axisymmetric spherical shells. Using numerical analysis the resulting displacements of the eyeball will be examined. The results of the scleral buckle may prove useful to predict changes in focal length.


2018 ◽  
Vol 2 (2) ◽  
pp. 79-86
Author(s):  
Razek Georges Coussa ◽  
Fares Antaki ◽  
Ali Dirani ◽  
Thomas Cordahi ◽  
Radwan Ajlan ◽  
...  

Purpose: To describe a surgical technique and report visual and anatomical outcomes after primary combined pars plana vitrectomy (PPV) and phacoemulsification in patients with posterior segment intraocular foreign bodies (IOFBs) removed via the anterior chamber without enlarging preexisting sclerotomies. Posterior IOFBs are generally managed in a stepwise surgery consisting of phacoemulsification/lensectomy for traumatic cataract removal then PPV and removal of IOFB through enlarged sclerotomies. Enlarged sclerotomies may carry a significant risk of hypotony, vitreous hemorrhage, vitreous and retinal incarceration, and rhegmatogenous retinal detachment with proliferative vitreoretinopathy. Limited studies exist on long-term results of primary anterior segment removal of posterior IOFB combined with primary phacoemulsification. Methods: Medical records of consecutive patients who had ocular lacerations and posterior segment IOFB between October 2003 and June 2017 in a university hospital were reviewed. Patients who received a combined primary IOFB removal and phacoemulsification were included in the study. The postoperative evolution including visual acuity and complications were all recorded. Results: Thirteen patients (13 eyes) were included in the study. All patients were men, and the average age at presentation was 38 years. All IOFB were metallic, and their size ranged from 2 to 7 mm. All patients were operated within 24 hours of presentation. Six (46%) of the 13 lacerations were corneal, and 7 (54%) were scleral. Overall, 9 of 13 (69%) had a final postoperative best-corrected visual acuity equal to or better than 20 of 25. There were 3 (23%) postoperative complications of recurrent rhegmatogenous retinal detachment that occurred within the first postoperative year. Conclusion: Primary combined PPV and phacoemulsification with the removal of IOFB via the anterior segment is a safe and promising approach for repairing open globe injuries. Our results demonstrate the favorable prognostic benefit of this technique, which is recommended in cases with small corneal laceration and posterior segment pathology resulting from IOFB.


Author(s):  
O.V. Diskalenko ◽  
◽  
O.A. Konikova ◽  
V.V. Brzheskiy ◽  
◽  
...  

Purpose. To study the etiological structure of rhegmatogenous retinal detachment, the efficacy and outcomes of its surgical treatment in pediatric practice. Material and Methods. A retrospective series of cases in one vitreoretinal center in 2015–2019 was presented. The age of the children with rhegmatogenous retinal detachment (57 patients / 66 eyes) was from 0 to 18. Surgical treatment included vitreoretinal and scleral buckling techniques. Results. Rhegmatogenous retinal detachment in 30.3% of cases developed against the background of ROP, in 24.2% – against the background of Stickler‘s syndrome, in 12.1% – against the background of myopia, in 12.1% – against the background of trauma, and in 21.3 % – against the background of other reasons. On average, the anatomical treatment efficacy was 77.4%. The leading factors of an unfavorable outcome of treatment were the duration of presence of retinal detachment (OR 21.44; CI 3.76– 122.16) and 3–5 stages ROP (OR 2.56; CI 0.76–8.44). Visual acuity exceeding the blindness threshold (Vis > 0.02) was maintained or achieved in 72% of cases. Conclusions. The specificity of the clinical course and adherence to surgical treatment of children with rhegmatogenous retinal detachment is determined by its etiology. Key words: retinal detachment in children, Stickler syndrome, retinopathy of prematurity, scleral buckling, vitreoretinal surgery.


2019 ◽  
Vol 4 (2) ◽  
pp. 110-118
Author(s):  
Mohamed Kamel Soliman ◽  
Harrish Nithianandan ◽  
Heather McDonald ◽  
Alexander J. Lingley ◽  
Raman Tuli

Purpose: To investigate the anatomical success rate associated with rhegmatogenous retinal detachment (RRD) repair without postoperative head positioning. Methods: Data on 182 individuals undergoing pars plana vitrectomy (PPV) with or without phacoemulsification or scleral buckle for primary RRD with intraocular tamponade were retrospectively reviewed. The primary outcome was the initial anatomical success rate. Secondary outcome measures were the change in best-corrected visual acuity and the final reattachment rate. Results: A total of 122 eyes from 122 patients who underwent RRD repair without postoperative positioning were included in this study. PPV alone was performed in 39% of cases, whereas the remaining patients had PPV combined with phacoemulsification (35%), with scleral buckle (19%), or both (7%). Inferior breaks between the 4 o’clock and 8 o’clock positions were present in 47% of cases. Primary and final anatomical success was achieved in 86% and 98% of cases, respectively. The most common cause for redetachment was proliferative vitreoretinopathy. Age and combined inferior retinal and superior breaks were predictive of recurrence in the logistic regression model. The mean baseline best-corrected visual acuity improved from 1.2 (Snellen equivalent, 20/320) to 0.76 (Snellen, 20/125) logarithm of the minimum angle of resolution after retinal reattachment ( P < .001). Conclusions: PPV combined with or without phacoemulsification or scleral buckle for primary RRD in pseudophakic eyes or those rendered pseudophakic is associated with good anatomical outcomes without restricted postoperative head positioning. Retinal detachment in eyes with combined retinal inferior and superior breaks may have a lower success rate, and whether this is due to lack of postoperative positioning needs further evaluation in prospective, controlled studies.


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