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H.F. Fine, R.N. Sjaarda, J.T. Thompson; The Risk of Subsequent Tear or Detachment After Radial Scleral Buckling and Intravitreal Gas Tamponade . Invest. Ophthalmol. Vis. Sci. 2003;44(13):2994.
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Purpose: Radial scleral buckling is often used to treat retinal detachments associated with solitary retinal tears. Injection of intravitreal gas may be used for internal tamponade in certain circumstances. We sought to determine the incidence and characteristics of subsequent retinal tear/detachment after radial buckling with intravitreal gas tamponade. Methods: A retrospective review of the medical records of a consecutive series of patients who underwent radial scleral buckling and injection of intravitreal gas without evidence of diabetic vitreoretinal traction was performed. Data collected included: age; gender; visit dates; eye(s) involved; initial, final, and best acuities; initial and subsequent tear/detachment location in clock-hours; presence of macular edema and epiretinal membrane; phakic status. Results: Eighty eyes of 80 patients met inclusion and exclusion criteria. There were a total of 23 second detachments over 183.4 total person-years, for an incidence of 0.125 per person/year. The mean time to a subsequent tear or detachment was 203 (range 8 - 1062) days. Second tears/detachments were not associated with demographic or ocular data including initial acuity, p=0.17, and phakic status, p=0.29 (Fisher's exact test). Second tears/detachments were predictive of greater decline in vision: -0.0048 (-0.3887,0.3792) v. 0.6111 (0.4020,0.8202) LogMAR units (95% confidence intervals), p = 0.006 (t-test). Conclusions: The annual incidence of retinal tear or detachment following radial buckling and intravitreal gas tamponade was 12.5%. Second tears and detachments were significantly associated with poorer visual outcomes.
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