Abstract
Abstract: :
Purpose: Scleral buckling procedures are a common and efficacious method for repair of retinal detachments. The purpose of this study is to investigate the risk of developing a retinal re-detachment after an initially successful scleral buckle. Encircling bands would theoretically help prevent secondary detachments because they support entire the vitreous base. This study attempts to investigate this. Methods: A retrospective review of patients with retinal detachments successfully repaired by scleral buckling procedures who subsequently re-detached was performed on patients admitted to Wills Eye hospital between 12/30/90 and 12/31/97. We excluded patients whose second admission for retinal detachment occurred within 90 days of the initial admission, as this was considered a failed initial repair. For each study eye, we examined pre-operative visual acuity, phakic status, size and location of retinal breaks, the presence of documented lattice and/or pathologic myopia, and the procedure performed (including the use of an encircling band in addition to the placement of segmental scleral elements). On readmission for subsequent retinal detachment, the pre-operative visual acuity, phakic status, size and location of retinal breaks was again re-examined. Results: Of 5846 patients admitted to Wills Eye Hospital from 12/30/90 to 12/31/97 with and for retinal detachment repair, 306 patients had a primary scleral buckling procedure, but were subsequently re-admitted for a recurrent retinal detachment. Conclusion: There is controversy regarding the need for encircling bands to support the entire vitreous base vs. segmental buckles or sponges alone during repair of retinal detachments. This study examines those patients who have a second retinal detachment after an initial successful repair via scleral buckle, and helps to characterize the risk factors involved in re-detachment.
Keywords: 563 retinal detachment • 628 vitreoretinal surgery