Clinical Study
Eye (2008) 22, 200–203; doi:10.1038/sj.eye.6702555; published online 1 September 2006
Scleral buckling combined with vitrectomy for the management of rhegmatogenous retinal detachment associated with inferior retinal breaks
No proprietary interests or research funding
P Alexander1, A Ang1, A Poulson1 and M P Snead1
1Department of Ophthalmology, Vitreoretinal Service, Addenbrooke's Hospital, Cambridge, UK
Correspondence: MP Snead, Department of Ophthalmology, Vitreoretinal Service, Addenbrooke's Hospital, Hills Road, Cambridge CB2 2QQ, UK. Tel: +44 1223 216701; Fax: +44 1223 217968. E-mail: mps34@ cam.ac.uk
Received 13 June 2006; Accepted 7 July 2006; Published online 1 September 2006.
Abstract
Aim
The use of adjunctive scleral buckling during vitrectomy for retinal detachment associated with inferior breaks has been the recent focus of some debate. It has been suggested that any benefit might be outweighed by potential complications associated with buckling surgery. The purpose of this study was to compare the success rate of vitrectomy, gas, and supplementary scleral buckling with the results of two recently published case series suggesting that acceptable results in inferior break detachments can be achieved with vitrectomy and gas alone.
Methods
A retrospective analysis of 60 consecutive patients with inferior break retinal detachments was conducted. All patients underwent vitrectomy, gas, and scleral buckling. In all cases, fellow eyes were examined under anaesthesia for retinal breaks if posterior vitreous detachment (PVD) had occurred at the time of presentation. Demographics, preoperative, and postoperative complications and outcome were recorded.
Results
Primary retinal attachment at 3 months was achieved in 95% of patients. This exceeds success rates of published data of patients who underwent vitrectomy and gas without buckling (81–89%). In patients with PVD in the fellow eye, 53% had horseshoe tears and all were treated with cryopexy. No sight-threatening complications occurred, but five patients developed minor buckle-related complications postoperatively.
Conclusion
Supplementary scleral buckling is a safe procedure that improves and enhances primary success rates in inferior break detachments over vitrectomy and gas without buckling. There is a high rate of PVD-related breaks requiring treatment in the fellow eyes.
Keywords:
retinal detachment, scleral buckling, vitrectomy
