Treatment of primary rhegmatogenous retinal detachment – scleral buckling or vitrectomy?

Ivanovska Adjievska, Biljana and Buckoska, Violeta and Spasov, Vladimir and Gjorgjioski, Sasho (2023) Treatment of primary rhegmatogenous retinal detachment – scleral buckling or vitrectomy? Acta Ophthalmologica, 1 (1). pp. 73-76. ISSN 1452-3868 (In Press)

Text SB vs PPV Acta Ophthal (2).pdf - Accepted Version Download (194kB)

Abstract

Background: Different surgical procedures
are performed in the management of
primary rhegmatogenous retinal
detachment (RRD) based on its complexity.
Aim: To compare the functional and
anatomical results of scleral buckling (SB)
and 23-gauge pars plana vitrectomy (PPV)
in management of primary RRD.
Methods: Retrospective study of 41 phakic
eyes with primary RRD treated in 1-yearperiod, with minimum 6 months follow up,
21 treated with SB and 20 with PPV. In the
SB procedure, all retinal breaks were
localized, cryotherapy was done, and
segmental scleral buckle was placed.
Drainage of subretinal fluid was performed.
In the standard 23-g PPV procedure, after
cauterization of all retinal breaks, endolaser
photocoagulation and tamponade with gas
or silicone oil was done. Improvement in
best corrected visual acuity (BCVA),
anatomical success, number of reoperations, cataract progression and
macular complications were compared.
Results: In 21 eyes in SB group, the mean
baseline BCVA was 0.28±0.31, the final
BCVA was 0.66±0.28. 2 eyes (9.5%)
needed re-surgery (PPV). In 20 eyes in PPV
group, the mean baseline BCVA was
0.11±0.16, the final BCVA was 0.34±0.25.
3 eyes (15%) needed re-surgery. Both SB
and PPV resulted in clinically significant
improvement of BCVA, better in SB group
(0.38 vs. 0.23 in PPV group). The
anatomical success was high in both groups,
better in the SB group (91.5% in SB vs.
85% in PPV). Permanent macular changes
were more frequent in PPV group (25% in
PPV vs. 14% in SB group). Cataract
progression was significantly higher in PPV
group (6 eyes (30%) vs. 3 eyes (14.2%) in
SB group).
Conclusion: Both procedures still have
significant roles in treatment of RRD. SB is
recommended as primary procedure in
younger patients with RRD in one quadrant,
to reduce early cataract surgery and possible
chronic macular complications. PPV,
especially phaco-vitrectomy, is probably a
better option in older patients, with
detachment in 2 or more quadrants and
longer duration of the RRD.

Item Type:	Article
Subjects:	Medical and Health Sciences > Clinical medicine
Divisions:	Faculty of Medical Science
Depositing User:	Biljana Ivanovska-Adzievska
Date Deposited:	29 Aug 2023 12:24
Last Modified:	29 Aug 2023 12:24
URI:	https://eprints.ugd.edu.mk/id/eprint/32105

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