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R. Regler, M. Afia, H. Helbig, C. Framme; Retinal Re-Detachment After Primary Buckling Surgery. Invest. Ophthalmol. Vis. Sci. 2010;51(13):6074.
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To evaluate the reasons for and the outcome after retinal re-detachment (RreD) following primary buckling surgery in rhegmatogenous retinal detachment.
Retrospective chart review. 89 eyes of 89 patients (male: 58, female: 31, age: 58.3 +/- 16.0) receiving primary buckling surgery (segmented buckling or encircling band) between October 1999 and August 2006 and suffering from subsequent retinal re-detachment (RreD) were included. The reasons for RreD were evaluated.
64 eyes (72%) had one RreD during the study course, in 25 eyes (28%) more RreDs occurred (2 in 14 eyes, 3 in 8 eyes and 4 in 3 eyes). At the end of the follow-up (9.5 +/- 9.6 months), all retinas were re-attached. Regarding the first RreD during the study course, proliferative vitreoretinopathy (PVR) was identified as the reason for detachment in 36 eyes (40%); in the other 53 eyes RreD occurred either because of new retinal breaks (n = 37; 42%), re-opening of old retinal breaks (n = 13; 15%) or a combination of both (n = 3; 3%). If PVR was already present before the initial surgery, it was likely that the following RreD was also caused by PVR (p < 0.001). Eyes with PVR were associated with a higher number of RreDs during the study course (p = 0.001) and a higher number of retinal breaks in the primary detachment (p = 0.025). Preoperative BCVA increased from 1.06 +/- 0.73 logMAR to 0.73 +/- 0.40 logMAR at the end of the follow-up (p < 0.001). The myopic shift caused by buckling surgery was 1.13 +/- 1.65 diopters (in eyes with unchanged lens status and no tamponade in situ at the end of the follow up; p = 0.018).
PVR is a threat for the successful treatment of retinal detachment with primary buckling surgery. In our study, re-detachments were mostly, in about equal shares, caused by PVR or by formation of new retinal breaks.
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