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Kazuhiko Umazume, Hiromichi Yagi, Yoshihiro Wakabayashi, Jun Suzuki, Keisuke Kimura, Hiroshi Goto; Scleral Buckling and Pars Plana Vitrectomy for Rhegmatogenous Retinal Detachment with inferior retinal tears. Invest. Ophthalmol. Vis. Sci. 2014;55(13):1085.
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© ARVO (1962-2015); The Authors (2016-present)
To investigate the anatomical success rates of scleral buckling (SB) and pars plana vitrectomy (PPV) performed for rhegmatogenous retinal detachment (RRD) with inferior tear and identify disparity between two surgical techniques.
Retrospective chart review of 377 patients who underwent PPV (163 patients) or SB (214 patients) for initial RRD between 2011 and 2012 at Tokyo Medical University Hospital. The number of RRD with inferior tear was 99 cases (PPV: 35, SB: 64). Inferior retinal tears were defined as tears located between 4 and 8 o’clock. RRD with atopic dermatitis, traumatic RD, RD with macula hole, RD with giant retinal teat and proliferative vitreoretinopathy (over grade C) were excluded from the study. In addition to the number of inferior retinal tears, success rate for each treatment was analyzed in relation to number of retinal tears, as well as the presence of macular detachment.
The primary anatomical success rate was 92.6% and 92.9% for PPV and SB group, respectively, and the final anatomical success rates were 100% in all patients with RRD. On the other hands, reattachment of the retina was achieved in 85.7% (PPV) and 92.8% (SB), respectively, for RRD patients with inferior tears. In SB group with inferior retinal tears, there was no statistic difference between group of success and failure. Although the presence of inferior retinal tear did not affect the success rate of SB, it significantly lowered success rate of primary PPV (p<0.05). In contrast, the number of retinal tears or the presence of macular detachment had no significant effect on success rates in both PPV and SB group.
While both PPV and SB produced excellent primary and final anatomical success rates, the management should be tailored to individual cases including inferior tears by PPV.
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