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N. P. Shah, G. J. Ko, D. M. Berinstein, R. A. Garfinkel, M. H. Osman; Surgical Outcomes in Eyes Failing Primary Retinal Detachment Repair With Scleral Buckle or Vitrectomy. Invest. Ophthalmol. Vis. Sci. 2007;48(13):5765.
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To evaluate and compare the surgical outcomes in eyes failing primary rhegmatogenous retinal detachment repair with either scleral buckle or vitrectomy.
Records of 298 consecutive eyes undergoing surgical repair with scleral buckle or vitrectomy for retinal detachment were retrospectively reviewed. All eyes had surgical repair at a single institution by multiple surgeons. Eyes developing a retinal re-detachment following primary repair were identified and further evaluated for the cause for redetachment, number of reoperations to achieve retinal reattachment, and associated complications.
Forty-six eyes of 298 subjects (15.4%) experienced a retinal redetachment following primary repair. Eighteen patients had a scleral buckle alone and 28 patients had vitrectomy alone. The average time for retinal redetachment was 105 and 297 days for the scleral buckle and vitrectomy eyes, respectively. The average number of reoperations required to achieve retinal reattachment was 1.7 in the eyes having primary vitrectomy and 1.5 for the scleral buckle group. All eyes having an initial scleral buckle underwent subsequent vitrectomy for redetachment repair. For eyes initial vitrectomy alone, 18 of the 28 eyes received a scleral buckle with vitrectomy at the time during repeat surgery.Common causes of retinal redetachment in the vitrectomy group were new retinal breaks, while proliferative vitreoretinopathy was more commonly seen in the scleral buckle group.
Scleral buckle surgery or vitrectomy alone is an effective treatment for the repair of rhegmatogenous retinal detachment. The underlying causes for redetachment differ between the two groups, however, the surgical outcomes and associated complications are similar with the vitrectomy group having a slightly higher number of reoperations.
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