Abstract
Abstract: :
Purpose: To evaluate anatomic results of scleral buckling in patients with primary rhegmatogenous retinal detachment. Study Design: Retrospective, observational, descriptive. Methods: Medical records of patients with primary rhegmatogenous retinal detachment that underwent scleral buckling performed by a retina fellow between January 1993 and March 2003 were reviewed. Patients with vitreous hemorrhage, proliferative vitreoretinopathy, recurrent retinal detachment or tractional retinal detachment were excluded. Minimum follow–up was 8 months. Results: Of the 325 records reviewed, 272 were included. Follow–up ranged from 8 months to 10 years. The majority of patients were male (57.7%). The right eye was affected in 57% of the cases. Myopia greater than 6 diopters was found in 29.4% of patients. The macula was involved in 56.12% of the cases. Procedures were performed by a first–year fellow in 66.2% of the cases and by a second–year fellow in 33.8%. Time from detachment to surgery was less than 12 hours in 1% of cases, 12 to 24 hours in 10%, 24 hours to 1 week 52% and 1 to 2 weeks in 37%. Subretinal fluid drainage was performed in 58% of the procedures. The superotemporal quadrant was affected in 76.6% of cases, superonasal in 12.8%, inferonasal in 9.5% and inferotemporal in 1.1%. General anesthesia was used in 89.2% of cases. Silicone band was used in 93% of patients. The most frequently used exoplant model was #220 in 76% of cases, #277 in 18%, and other in 5%. Cryotherapy was used in 84% of cases. No tamponade was used in 87% of cases, gas was used in 12% and air in 1%. The most frequent complication encountered during the procedure was vitreous hemorrhage posterior subretinal liquid drainage in 2.9% of cases. The most frequent post–surgical complication was re–detachment in 11.4% of cases. Anatomic success was encountered in 86.8% of cases (90% for first–year fellows and 87% for second–year fellows with no statististically significant difference). Conclusions: Anatomic results of scleral buckling in patients with primary rhegmatogenous retinal detachment are directly related to time from presentation to surgery and retinal detachment area. Our results in general is similar with other reports in the literature. This technique can be reproduced with an adequate teaching.
Keywords: retinal detachment • clinical (human) or epidemiologic studies: outcomes/complications