Scleral Buckling Versus Vitrectomy for Macula-off Rhegmatogenous Retinal Detachment As Accessed with Spectral-domain Optical Coherence Tomography: a Retrospective Observational Case Series

Overview

Journal BMC Ophthalmol

Publisher Biomed Central

Specialty Ophthalmology

Date 2013 Apr 17

PMID 23587195

Citations 12

Authors

Chunmei Huang

Te Fu

Tonghe Zhang

Xinyi Wu

Qiang Ji

Ruili Tan

Affiliations

Soon will be listed here.

Abstract

Background: Scleral buckling surgery and pars plana vitrectomy are competing methods in the treatment of retinal detachment. The recent development of spectral-domain optical coherence tomography (SD-OCT) has dramatically improved the visualization of the photoreceptor layer relative to conventional OCT, and offers new opportunities to investigate the discordances between anatomic and functional outcomes after retinal detachment surgery. Hence, the study aim was to use SD-OCT to compare the postoperative macular recovery between scleral buckling and vitrectomy for macular-off rhegmatogenous retinal detachment.

Methods: In this retrospective observational case series, we observed 32 patients who underwent scleral buckling surgery (group 1) and 26 patients who underwent pars plana vitrectomy (group 2) as the primary surgery for macula-off rhegmatogenous retinal detachment. OCT was used to examine microstructural changes in the macular area.

Results: The mean visual acuity improvement was 0.4 ± 0.8 logMAR in group 1 and 0.7 ± 0.9 logMAR in group 2. As detected by SD-OCT, subretinal fluid was present in 26 of the group 1 eyes (81.3%) and 5 of the group 2 eyes (19.2%) at 8 weeks postoperatively.This difference was statistically significant (Fisher's exact test, P < 0.05). Moreover, detection by SD-OCT revealed epiretinal membranes in 5 of the group 1 eyes (15.6%) and 11 of the group 2 eyes (42.3%), a difference that was statistically significant (Fisher's exact test, P < 0.05).

Conclusions: Macular recovery and the mean visual acuity differed between the 2 groups of patients. With the help of SD-OCT, we observed that subretinal fluids could persist for a relatively longer period after scleral buckling. Based on our results, we conclude that primary vitrectomy surgery is a better choice for macular recovery of the macula-off rhegmatogenous retinal detachment.

Citing Articles

Comparing the Randomized Trial Outcomes of 3D Low-Light Intensity-Assisted and Traditional Eyepiece-Assisted Pars Plana Vitrectomy for Rhegmatogenous Retinal Detachment.

Ge X, Liu D, Liu Y, Fan F, Wang Y, Zhang Z Ophthalmic Res. 2024; 68(1):90-99.

PMID: 39715605 PMC: 11844667. DOI: 10.1159/000543135.

Effect of external subretinal fluid drainage on persistent subretinal fluid after scleral buckle surgery in macula-involving rhegmatogenous retinal detachment.

Do J, Park D, Shin J, Kang Y Sci Rep. 2023; 13(1):22176.

PMID: 38093092 PMC: 10719269. DOI: 10.1038/s41598-023-49719-5.

Evaluation of epiretinal membrane formation after scleral buckling for treating rhegmatogenous retinal detachment: En face optical coherence tomography image-based study.

Matoba R, Kanzaki Y, Morita T, Kimura S, Hosokawa M, Shiode Y Graefes Arch Clin Exp Ophthalmol. 2023; 262(2):469-476.

PMID: 37864637 DOI: 10.1007/s00417-023-06285-w.

Optical Coherence Tomography Findings in Rhegmatogenous Retinal Detachment: A Systematic Review.

Danese C, Lanzetta P J Clin Med. 2022; 11(19).

PMID: 36233684 PMC: 9571044. DOI: 10.3390/jcm11195819.

Effect of High Myopia on Delayed Absorption of Subretinal Fluid after Scleral Buckling Surgery.

Meng Y, Long K, Chen J, Luo J J Clin Med. 2022; 11(13).

PMID: 35807191 PMC: 9267211. DOI: 10.3390/jcm11133906.

References

Tewari H, Kedar S, Kumar A, Garg S, Verma L . Comparison of scleral buckling with combined scleral buckling and pars plana vitrectomy in the management of rhegmatogenous retinal detachment with unseen retinal breaks. Clin Exp Ophthalmol. 2003; 31(5):403-7. DOI: 10.1046/j.1442-9071.2003.00686.x. View

. View 2: the case for primary vitrectomy. Br J Ophthalmol. 2003; 87(6):784-7. PMC: 1771700. DOI: 10.1136/bjo.87.6.784. View

Wickham L, Connor M, Aylward G . Vitrectomy and gas for inferior break retinal detachments: are the results comparable to vitrectomy, gas, and scleral buckle?. Br J Ophthalmol. 2004; 88(11):1376-9. PMC: 1772385. DOI: 10.1136/bjo.2004.043687. View

Landa G, Rosen R, Garcia P, Seiple W . Combined three-dimensional spectral OCT/SLO topography and Microperimetry: steps toward achieving functional spectral OCT/SLO. Ophthalmic Res. 2009; 43(2):92-8. DOI: 10.1159/000247593. View

Afrashi F, Erakgun T, Akkin C, Kaskaloglu M, Mentes J . Conventional buckling surgery or primary vitrectomy with silicone oil tamponade in rhegmatogenous retinal detachment with multiple breaks. Graefes Arch Clin Exp Ophthalmol. 2004; 242(4):295-300. DOI: 10.1007/s00417-003-0842-2. View

Hagimura N, Iida T, Suto K, Kishi S . Persistent foveal retinal detachment after successful rhegmatogenous retinal detachment surgery. Am J Ophthalmol. 2002; 133(4):516-20. DOI: 10.1016/s0002-9394(01)01427-1. View

Kreissig I . View 1: minimal segmental buckling without drainage. Br J Ophthalmol. 2003; 87(6):782-4. PMC: 1771722. DOI: 10.1136/bjo.87.6.782-a. View

Holz E, Mieler W . View 3: The case for pneumatic retinopexy. Br J Ophthalmol. 2003; 87(6):787-9. PMC: 1771712. DOI: 10.1136/bjo.87.6.787. View

Bartz-Schmidt K, Kirchhof B, Heimann K . Primary vitrectomy for pseudophakic retinal detachment. Br J Ophthalmol. 1996; 80(4):346-9. PMC: 505463. DOI: 10.1136/bjo.80.4.346. View

10.

Tani P, Robertson D, Langworthy A . Prognosis for central vision and anatomic reattachment in rhegmatogenous retinal detachment with macula detached. Am J Ophthalmol. 1981; 92(5):611-20. DOI: 10.1016/s0002-9394(14)74651-3. View

11.

Duquesne N, Bonnet M, Adeleine P . Preoperative vitreous hemorrhage associated with rhegmatogenous retinal detachment: a risk factor for postoperative proliferative vitreoretinopathy?. Graefes Arch Clin Exp Ophthalmol. 1996; 234(11):677-82. DOI: 10.1007/BF00292353. View

12.

Wong D, Billington B, CHIGNELL A . Pars plana vitrectomy for retinal detachment with unseen retinal holes. Graefes Arch Clin Exp Ophthalmol. 1987; 225(4):269-71. DOI: 10.1007/BF02150146. View

13.

Spiegel D, NASEMANN J, Nawrocki J, Gabel V . Severe ocular trauma managed with primary pars plana vitrectomy and silicone oil. Retina. 1997; 17(4):275-85. DOI: 10.1097/00006982-199707000-00001. View

14.

Wolfensberger T, Gonvers M . Optical coherence tomography in the evaluation of incomplete visual acuity recovery after macula-off retinal detachments. Graefes Arch Clin Exp Ophthalmol. 2002; 240(2):85-9. DOI: 10.1007/s00417-001-0410-6. View

15.

Swanson E, Izatt J, Hee M, Huang D, Lin C, Schuman J . In vivo retinal imaging by optical coherence tomography. Opt Lett. 2009; 18(21):1864-6. DOI: 10.1364/ol.18.001864. View

16.

McLeod D . Is it time to call time on the scleral buckle?. Br J Ophthalmol. 2004; 88(11):1357-9. PMC: 1772381. DOI: 10.1136/bjo.2004.050146. View

17.

Pournaras C, Kapetanios A . Primary vitrectomy for pseudophakic retinal detachment: a prospective non-randomized study. Eur J Ophthalmol. 2003; 13(3):298-306. DOI: 10.1177/112067210301300310. View

18.

Ghartey K, TOLENTINO F, Freeman H, McMeel J, Schepens C, Aiello L . Closed vitreous surgery. XVII. Results and complications of pars plana vitrectomy. Arch Ophthalmol. 1980; 98(7):1248-52. DOI: 10.1001/archopht.1980.01020040100014. View

19.

Richardson E, Verma S, GREEN W, Woon H, CHIGNELL A . Primary vitrectomy for rhegmatogenous retinal detachment: an analysis of failure. Eur J Ophthalmol. 2000; 10(2):160-6. DOI: 10.1177/112067210001000212. View

20.

Schwartz S, Kuhl D, McPherson A, Holz E, Mieler W . Twenty-year follow-up for scleral buckling. Arch Ophthalmol. 2002; 120(3):325-9. DOI: 10.1001/archopht.120.3.325. View