J Korean Ophthalmol Soc.  2020 Nov;61(11):1302-1310. 10.3341/jkos.2020.61.11.1302.

Surgical Results of Scleral Buckling without Subretinal Fluid Drainage in Patients with Primary Rhegmatogenous Retinal Detachment

• Han SU
• Choi HJ
• Song JH

• KMID: 2511267
• DOI: http://doi.org/10.3341/jkos.2020.61.11.1302

Abstract

Purpose
To assess the clinical outcomes of scleral buckling (SB) without subretinal fluid drainage (SRFD) on primary rhegmatogenous retinal detachment (RRD).
Methods
The medical records of patients with RRD treated via SB without SRFD from March 2009 to Feb 2018 were retrospectively reviewed. Cases with histories of previous intraocular surgery (except cataract removal) were excluded. The primary and final surgical success rates were the main outcome measures. Pre- and post-operative visual acuity and intraocular pressure (IOP), factors that might affect the surgical success rate, secondary operative procedures, re-operation rates, and complications were analyzed.
Results
A total of 66 eyes of 66 patients were included. The mean patient age was 38.9 ± 18.6 years and the mean symptom duration 19.23 ± 25.14 days. The retinae were reattached after single surgeries on 57 eyes (success rate 86.36%); the final success rate was 100% after a second operation (when necessary). Of the nine eyes requiring additional surgery, seven required vitrectomy and two vitrectomy combined with buckle revision. The mean preoperative logMAR visual acuity of 0.578 ± 0.647 improved to 0.518 ± 0.512 at 1 month after surgery (p < 0.001) and to 0.262 ± 0.372 at the last follow-up visit (p < 0.001). The postoperative IOP was higher than the preoperative IOP at 3 months (p = 0.024).
Conclusions
Scleral buckling without SRFD used to treat primary RRD afforded a high reattachment rate (compared to those of previous reports employing vitrectomy or scleral buckling with SRFD). Given the possible complications of SRFD, our method may be a safe and feasible surgical option, affording good results with few complications in patients with primary RRD.

Keyword

Rhegmatogenous retinal detachment; Scleral buckle; Subretinal fluid drainage; Vitrectomy