Twenty-Year Follow-up for Scleral Buckling

Abstract

To the report 20-year follow-up data for patients receiving a scleral buckle for treatment of a primary rhegmatogenous retinal detachment (RRD).Methods: Nonconsecutive, retrospective case series. We identified 227 eyes with primary RRD who were treated with a scleral buckle, and for whom at least 20 years of follow-up data were available. Results were classified into 3 subgroups: retina reattached with 1 procedure; retina reattached with 1 or more additional vitreoretinal procedures; or retina detached at 20 years.Results: One hundred eighty-six eyes (82%) achieved retinal reattachment with 1 scleral buckling procedure and with a median final visual acuity of 20/40 at 20 years of follow-up. An additional 30 eyes (13%) achieved reti-nal reattachment after 1 or more additional vitreoretinal procedures, with a median final visual acuity of 20/50. Eleven eyes (5%) were detached at the 20-year follow-up examination, with a final visual acuity in all eyes of no light perception.Conclusions: Scleral buckling for primary RRD achieves anatomical efficacy and preservation of central vision in the majority of eyes at 20 years' follow-up. The 1-operation success rate was 82%, overall success rate was 95%, and median final visual acuity was 20/40. This study may serve as a basis for comparison with the long-term results of other surgical techniques used in the treatment of primary RRDs.

Vision-related quality of life, metamorphopsia, and stereopsis after successful surgery for rhegmatogenous retinal detachment

“…Postoperative VA, metamorphopsia, and stereopsis Some studies suggested that scleral buckling and vitrectomy surgery, which anatomically corrects RRD, do not restore visual function, as measured by VA. [12][13][14] In our study, after scleral buckling or vitrectomy to correct RRD, postoperative VA improved significantly compared with preoperative VA in agreement with previous studies. [14][15][16] Scholars suggested that preoperative VA was the key to determine postoperative visual recovery.…”

LASER demarcation photocoagulation for rhegmatogenous retinal detachments

“…It may be that selecting eyes with symptomatic retinal detachments of more limited extent (anterior to the equator) that are smooth and shallow, as in the study by Vrabec and Baumal, 3 produces better results. Certainly, for eyes with symptomatic retinal detachments the failure rate of 5/13 (38.5%) is rather high in our study and higher than published rates of pneumatic retinopexy, 16 scleral buckling, 17,18 or pars plana vitrectomy. 19 However, in patients who are apprehensive of invasive surgery or for patients who may be infirm and poor surgical candidates (eg unable to lay flat due to severe emphysema, heart failure, or severe kyphosis) or who do not have the resources for operative repair (lack of ophthalmologist trained in scleral buckling or vitrectomy) DLP may represent a good option.…”

Scleral buckling versus primary vitrectomy in rhegmatogenous retinal detachment study (SPR Study): recruitment list evaluation. Study report no. 2

“…Numerous studies have been published recommending one of the two methods [1,4,13,14,20,24,26,27,29,30,32]. We could identify no consensus among several editorial comments on this issue [6, 15-18, 33, 34].…”