Abstract
Purpose :
To evaluate the visual and anatomic outcomes of patients who underwent a scleral buckle (SB) as a secondary procedure for failed primary pneumatic retinopexy (PR) in the repair of rhegmatogenous retinal detachments (RRD).
Methods :
This is a retrospective, single-center, consecutive case series of patients from 2009 to 2020 with a RRD who failed a primary PR and underwent a secondary SB repair. Patients with at least six months of post-operative follow-up were included in the study. Demographic information, pre-operative characteristics, parameters of the failed PR, parameters of the subsequent SB procedure, and serial optical coherence tomography (OCT) imaging data were recorded. The data was analyzed using ANOVA with statistical significance level set at 0.05.
Results :
A total of 57 patients (59.7% male, mean age of 47 ± 15 years old) were included in our study, with a mean follow-up was 48.6 ± 31.8 months. 26 right eyes and 31 left eyes were identified, and all eyes were phakic. The mean total number of clock hours in the initial RRD was 4.1 ± 1.6, and 45.6% of patients had macula-off RRD, with over 36% having more than one retinal break. The average time to PR failure was 7.6 ± 11.2 days, and 61% had the secondary SB procedure within a week. Visual acuity (VA) in (LogMar [Snellen equivalent]) at presentation (0.72 ± 0.82 [20/70]) and at time of PR failure (0.51 ± 0.47 [20/65]) were not significantly different (p=0.487).
At six months post-SB repair, VA was (0.42 ± 0.37 [20/53]). VA at twelve months and at final follow-up were (0.35 ± 0.34 [20/45]) and (0.27 ± 0.30 [20/37]) respectively, both of which were significantly better than the initial visual acuity (p=0.032 and p=0.002, respectively). Thirteen patients (13/57, 23%) required at least one additional surgery. Reasons for additional surgery included: non-resolving subretinal fluid on serial OCT (6/13, 46.1%), new breaks (5/13, 38.5%) or proliferative vitreoretinopathy (2/13, 15.4%). The average time to secondary surgery was 84. ± 201 days.
Conclusions :
Among phakic patients who fail PR for RRD, SB remains a viable alternative with acceptable anatomical and functional outcomes at six months and one year follow-up respectively.
This is a 2021 ARVO Annual Meeting abstract.