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Anna Gabrielian, Jack A. Cohen, Joseph M. Civantos, John S. Pollack, Mathew M. MacCumber, Pauline T. Merrill, Sohail J. Hasan, Zac B. Ravage, Kirk H. Packo, Kourous Rezaei; Scleral Buckling Surgery for Rhegmatogenous Retinal Detachment. Invest. Ophthalmol. Vis. Sci. 2011;52(14):6164.
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© ARVO (1962-2015); The Authors (2016-present)
To review characteristics and outcomes of patients who underwent scleral buckling (SB) surgery for repair of rhegmatogenous retinal detachment (RRD) in a multi-office retina practice.
A retrospective chart review was conducted on patients who underwent primary SB surgery from 2005 to 2009 by ten surgeons. Patients with <6 months of follow-up were excluded. Data collected on each patient included: duration of follow-up, age, sex, lens status, presence of posterior vitreous detachment (PVD), vitreous hemorrhage (VH), lattice degeneration, myopia, proliferative vitreoretinopathy (PVR), macular status, mean number of retinal breaks, extent of RRD, pre-operative and final visual acuity (VA), the number of procedures needed to reattach the retina, and the final anatomic status of retina.
135 eyes of 133 patients were evaluated. Mean follow-up was 29.8 months (range, 6-62). Mean age was 48 years (range, 5-85). Seven eyes (5.2%) were pseudophakic, 31.1% had lattice degeneration, 57% were myopic, 41.5% had PVD, 6.7% had VH and 10.4% had PVR upon presentation. The mean number of retinal breaks was 1.8 (range, 1-6) and the mean extent of RRD was 4.9 clock hours (range, 1.5-12). Macula was detached in 67 eyes (49.6%). Reattachment rate after one surgical procedure was 87.4% (118/135), while overall reattachment rate was 100%. The mean initial VA was 20/100 (range, 20/15 - light perception (LP)) and mean final VA was 20/40 (range, 20/20 - 2/200). In macula off RRDs, the mean initial VA was 20/100 (range, 20/15 - LP), and the mean final VA was 20/40 (range 20/15 - 2/200). 62.7% of macula off RRDs had final VA of 20/40 or better, while 72% of macula on RRDs had final VA of 20/40 or better. Seventeen eyes (12.6%) required more than one procedure to reattach the retina: twelve eyes (8.9%) re-detached, five (3.7%) had persistent subretinal fluid. Three eyes (2.2%) developed epiretinal membranes requiring surgery, two eyes (1.5%) required SB removal, and one eye (0.7%) developed a macular hole.
Primary SB leads to successful anatomic reattachment with significant visual improvement. 12.6% of eyes required more than one procedure to reattach the retina. A significant number of patients with macula off RRD developed a visual acuity of 20/40 or better.
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