Non-drainage scleral buckling with solid silicone elements

Abstract

Background:With the increasing number of cataract surgeries, incidence of posterior segment complications including rhegmatogenous retinal detachment (RRD) is likely to rise. Scleral buckling (SB) surgery is an effective and less expensive option. The primary advantage of non-drainage procedure is avoidance of possible complications associated with trans-choroidal drainage. The aim of present study is to describe the clinical profile of subjects undergoing non-drainage SB surgery with solid silicone elements for RRD and analyze their treatment outcomes.Materials and Methods:This was a retrospective, non-randomized, interventional study at a tertiary care center. Three hundred and six eyes of 298 patients undergoing non-drainage SB surgery with solid silicone elements from year 2000 to 2006 were included. Inclusion criteria were primary RRD, peripheral depressible retinal break, media clarity affording peripheral retinal view and proliferative vitreo-retinopathy (PVR) up to grade C2. Uni- and multivariate analyses was done to analyze factors affecting anatomical and visual outcomes. Statistical analysis was performed using SPSS Version 10.Results:Mean follow-up was 303 ± 393.33 days. Primary anatomical success was obtained in 279 (91.2%) eyes; primary functional success in 286 (93.5%) eyes. PVR (grade B or C), intraocular pressure <10 mm Hg and the inability to find a retinal break were significantly associated with final anatomical failure. Baseline vision ≤3/60 was significantly associated with poor visual recovery.Conclusions:SB surgery is reasonably safe and highly efficacious. Solid silicone elements are effective in non-drainage SB surgery. However, case selection is important.

Outcome of Non-drainage Scleral Buckling in Primary Rhegmatogenous Retinal Detachment

“…All eyes achieving primary anatomical success (84.6%) showed complete SRF absorption within 1 week, mean time of absorption being 3.14 days in our study. Similar study by Rishi et al found that complete absorption of SRF was seen in 75% eyes within 1 week and in 86% eyes within 6 weeks (Rishi, et al, 2014). Although some studies have reported correlation of SRF absorption with patients' age, subretinal precipitates, and duration and extent of RD (O'Connor, 1973) (Chignell, 1974); others have found no such association (Rishi, et al, 2014).…”

“…Also they found no difference in the anatomical success between PPV and scleral buckling alone (Wong, et al, 2014). Rishi et al reported primary reattachment rate of 91.2% following non-drainage scleral buckling procedure (Rishi, et al, 2014). Haritoglou et al and Sasoh et al reported primary success rate of 84.7% and 91.2% respectively (Haritoglou, et al, 2010) (Sasoh, et al, 2005).…”

“…Duration of retinal detachment has been consistently associated with postoperative visual acuity following retinal reattachment surgery (Doyle, et al, 2007) (Kim, et al, 2013) (Mitry, et al, 2013). Preoperative visual acuity has also been found to be associated with final Agarwal L and Agarwal N Non-drainage Scleral Buckling in Retinal Detachment Nepal J Ophthalmol 2021;Vol 13 (25): 65-72 visual outcome following retinal reattachment procedure (Doyle, et al, 2007) (Friberg & Eller, 1992) (Liu, et al, 2006) (Rishi, et al, 2014) (Wong, et al, 2014). Some studies have shown preoperative factors, like disruption of retinal morphology and irreversible damage to photoreceptors, as important determinant of postoperative visual acuity (Delolme, et al, 2012) (Schocket, et al, 2006) (Wakabayashi, et al, 2009).…”

Non Drainage Scleral Buckling Surgery

“…Scottish retinal detachment study published in 2011 reported primary success rate to be approximately 81% [11]. Rishi, et al performed non-drainage surgery in 306 eyes of 298 patients and reported primary anatomical success of 91% [12]. Proliferative vitreoretinopathy is one of the factor which can modify our approach to treat RD.…”

“…This might be one of the reasons for higher anatomic success in our study as we selected patients of 50 years or less. Scleral buckling results in terms of anatomic success are more or less the same when SRF is drained or not [3,[4][5][6][7][8][9][10][11][12][13][14][15][16][17]. However, the surgical complications are more in the SRF drainage group like sub-retinal hemorrhage, choroidal detachment, infections, vitreous and retinal incarcerations [2].…”