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Mohammed Khuthaila, Mahta Rasouli, Marc Spirn, Sunir J. Garg, Mark Greve, Matthew Tennant, Jason Hsu; Outcomes of Scleral Buckle Removal Combined with Prophylactic Laser Retinopexy. Invest. Ophthalmol. Vis. Sci. 2012;53(14):6356.
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To determine whether intra-operative laser retinopexy at the time of scleral buckle removal decreases the rate of recurrent retinal detachment.
Retrospective, non-randomized, cohort study. All patients known to have had scleral buckle removal from Wills Eye Institute and University of Alberta from 2000 to 2011 were identified. Additional inclusion criteria were the initial diagnosis of primary rhegmatogenous retinal detachment requiring scleral buckle surgery and minimum follow-up of 6 months after buckle removal. The exclusion criteria were the absence of clinical documentation or lack of follow-up.
Eighty-eight patients met criteria for inclusion in this study. Primary indications for scleral buckle removal were extrusion (75%, n=66), diplopia (7.9%, n=7), infection (6.8%, n=6), a combination of extrusion and infection (5.7%, n=5), and others (4.5%, n=4). Duration of implant significantly differed by type, with patients in the Band group having the shortest duration of implant (52 months, range 1-403 month), and those with Band plus Segment having the longest (114 months, range 7-285 months) (p=0.003). The group that received laser retinopexy at the time of scleral buckle removal had a re-detachment rate of 2.2%, whereas the group that did not receive laser had a re-deatchment rate of 4.6%. Using the Fisher exact test, we found no significant difference between the two (p=0.61).
Both groups had a low rate of recurrent retinal detachment after scleral buckle removal. Prophylactic laser did not appear to significantly reduce the rate of recurrent retinal detachment.
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