June 2022
Volume 63, Issue 7
Open Access
ARVO Annual Meeting Abstract  |   June 2022
Scleral buckle removal in patients with rhegmatogenous retinal detachment
Author Affiliations & Notes
  • Eunice You
    Ophtalmologie, CHU de Quebec-Universite Laval, Quebec, Quebec, Canada
  • Mohammadhossein Ghasempourabadi
    Universite Laval, Quebec, Quebec, Canada
  • Mélanie Hébert
    Ophtalmologie, CHU de Quebec-Universite Laval, Quebec, Quebec, Canada
  • Sihame Doukkali
    Universite Laval, Quebec, Quebec, Canada
  • Serge Bourgault
    Ophtalmologie, CHU de Quebec-Universite Laval, Quebec, Quebec, Canada
  • Mathieu Caissie
    Ophtalmologie, CHU de Quebec-Universite Laval, Quebec, Quebec, Canada
  • Éric Tourville
    Ophtalmologie, CHU de Quebec-Universite Laval, Quebec, Quebec, Canada
  • Ali Dirani
    Ophtalmologie, CHU de Quebec-Universite Laval, Quebec, Quebec, Canada
  • Footnotes
    Commercial Relationships   Eunice You None; Mohammadhossein Ghasempourabadi None; Mélanie Hébert None; Sihame Doukkali None; Serge Bourgault None; Mathieu Caissie None; Éric Tourville None; Ali Dirani None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2022, Vol.63, 3449 – F0349. doi:
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    • Get Citation

      Eunice You, Mohammadhossein Ghasempourabadi, Mélanie Hébert, Sihame Doukkali, Serge Bourgault, Mathieu Caissie, Éric Tourville, Ali Dirani; Scleral buckle removal in patients with rhegmatogenous retinal detachment. Invest. Ophthalmol. Vis. Sci. 2022;63(7):3449 – F0349.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Scleral buckling (SB) can be used alone or in combination with pars plana vitrectomy (PPV) for the treatment of rhegmatogenous retinal detachment (RRD). In specific cases, buckle removal is necessary due to SB-related complications. The purpose of this study is to investigate the indications of SB removal and the rate of recurrent retinal detachment in these patients.

Methods : This was a retrospective cohort study. The medical records of eyes operated for RRD with SB (simple SB or in combination with PPV) at CHU de Québec – Université Laval (Quebec City) between 2008 and 2020 were reviewed. Exclusion criteria included non-RRD of tractional or traumatic etiology. The indications for all cases of SB removal were reviewed. The primary outcome of interest was recurrence of retinal detachment following SB removal.

Results : Out of 2375 eyes that underwent SB for treatment of RRD, 40 eyes had SB removal (1.7%). The main indication for SB removal was infection, occurring in almost a third of patients (n=13, 32.5%). Pain/intolerance (n=12, 30%), buckle extrusion (n=6, 15%), strabismus and/or diplopia (n=3, 7.5%) and other causes including persistent inflammation and increased intraocular pressure (n=6, 15%) made up the remaining indications. The median time from scleral buckle placement to removal was 11.5 months, but in 25 cases (62.5%), the buckles were removed after less than 6 months, and an additional 37.5% (n=15) of cases after more than 1 year. Patients who had infection as the primary cause of SB removal were likely to have earlier removal of SB (median [Q1, Q3] in months) than those with SB removal for other reasons (infection: 2.8 [1.1, 9.5] vs. other causes: 11.2 [6.3, 25.1]; p=0.012).

After SB removal, recurrent retinal detachment was observed in 7.5% of eyes (n=3), with all recurrences occurring within the first month. All patients underwent PPV without placement of a SB. Re-detachment occurred in all three patients within the first 6 months.

Conclusions : The indications for SB removal are numerous, with infection making up one third of cases and generally necessitating earlier intervention. There is a 7.5% risk of redetachment after SB removal. Additionally, treatment of recurrent RRD post-SB removal is associated with a high rate of failure and should therefore be carefully considered.

This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.

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