Scleral buckling and vitrectomy combination is the most successful in retinal reattachment

September 5, 2011

A combination of scleral buckling and vitrectomy produced better anatomical success rates and fewer operative procedures in surgery for primary retinal detachment patients.

A combination of scleral buckling and vitrectomy produced better anatomical success rates and fewer operative procedures in surgery for primary retinal detachment patients, according to a study published in Retina.

Dr Schaal Shlomit et al., Department of Ophthalmology and Visual Sciences, University of Louisville, Kentucky, USA, conducted a retrospective interventional comparative case series on 1226 primary retinal detachment patients. The patients were split in to 4 groups: 56 patients underwent pneumatic retinopexy surgery, 316 patients underwent both scleral buckling and vitrectomy surgery, 322 patients underwent scleral buckling surgery and 442 patients had pars plana vitrectomy surgery.

Outcome measures included reattachment success rates, pre- and postoperative visual acuity, complications, and change in refractive error. A 1-year follow-up was completed on all patients.

The results demonstrated an 86% initial success rate for scleral buckling only, 90% for vitrectomy only, 94% for scleral buckling and vitrectomy and 63% for pneumatic retinopexy surgery.

With exception of the pneumatic retinopexy group, there were no statistically significant differences between the other 3 groups. There were also no statistically significant differences in visual acuity between all of the groups.

Overall, the most successful techniques for the repair of primary rhegmatogenous retinal detachments are scleral buckling used in conjunction with vitrectomy, as well as scleral buckling only and vitrectomy only.