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H. A. Chaudhry, H. H. Pham, M. H. Colyer, D. M. Berinstein; Outcomes of Scleral Buckle Surgery Using Smaller Size Buckling Materials. Invest. Ophthalmol. Vis. Sci. 2010;51(13):1761.
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© ARVO (1962-2015); The Authors (2016-present)
To study the outcomes of scleral buckle surgery for the treatment of rhegmatogenous retinal detachment using a single silicone rubber element measuring 4.0 mm or less.
A retrospective case series of 93 eyes of 92 patients undergoing scleral buckle surgery for rhegmatogenous retinal detachment between 2002 and 2008 by a single surgeon. Subjects were excluded if they had concurrent or prior vitrectomy or pneumatic retinopexy. Subjects were grouped as either having a single encircling element measuring ≤4.0 mm in width or a larger 2-piece element measuring >4.0 mm in width. Data recorded included patient age, gender, pre-operative & post-operative visual acuities, buckle element size, change in refraction, and intraoperative & postoperative adverse events. Snellen visual acuities were converted to logarithm of the minimum angle of resolution (logMAR) best corrected visual acuity (BCVA) for statistical analysis.
Sixty-four (71%) of the subjects were men and 28 (29%) were women with a mean age of 51.7 years (range, 10-81). A total of 50 patients received a ≤ 4.0 mm scleral buckle element and 43 had a > 4.0 mm element. The preoperative vision in the smaller size scleral buckle group was 20/68 and 20/66 for the larger size group, with the postoperative visual acuities being 20/30 and 20/31, respectively. The change in refraction will be reported. Overall, a 94.5% reattachment rate was achieved with 1 eye re-detaching in the smaller element group and 4 eyes re-detaching in the larger element group (p = 0.468). Post-operative complications seen included transient ocular hypertension (49.5%), epiretinal membrane (19.4%), and diplopia (8.6%). The most common complications seen in the smaller element group aside from ocular hypertension were diplopia (10.4%) and epiretinal membrane (10.4%), while epiretinal membrane (30.2%) was found to be the most common in the larger element group. No intraoperative complications late scleral buckle extrusions or infections were seen in either group.
The outcome of scleral buckling surgery using smaller size buckling materials is similar to larger elements. The complications seen are comparable, with epiretinal membrane being slightly higher in the larger element group. Our findings suggest that larger elements may not be necessary to achieve a successful anatomical outcome. Further investigation is warranted to determine if the size of the buckle material used impacts the anatomical outcome and/or lessens adverse events.
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