A Comparative Study of Scleral Buckling and Pars Planar Vitrectomy for Primary Rhegmatogenous Retinal Detachment (original) (raw)
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Clinical ophthalmology (Auckland, N.Z.), 2017
To assess the combination of scleral buckling (SB) and pars plana vitrectomy (PPV) versus PPV alone in the primary repair of rhegmatogenous retinal detachments (RRDs). The current study was a retrospective, comparative, interventional, consecutive case series of 179 eyes of 174 patients who underwent primary RRD repair by five surgeons between January 1, 2008 and December 31, 2010, utilizing SB with PPV or PPV. Univariate and multivariate analyses were used to compare the efficacy of the two surgical strategies and assess for risk factors of proliferative vitreoretinopathy (PVR). Single surgery anatomic success (SSAS) was similar (P=0.76) between the PPV group (112 of 132 eyes, 85%) and SB with PPV group (39 of 47 eyes, 83%). Final anatomic success was 100% in each group. There was no difference in rates of PVR formation (PPV 16% vs SB with PPV 19%, P=0.70). Final logarithm of the minimum angle of resolution acuity was 0.33 (20/43) in the PPV group and 0.37 (20/47) in the SB with PP...
Graefe's Archive for Clinical and Experimental Ophthalmology, 2001
Background: In patients with more complex rhegmatogenous retinal detachments (RRD) not complicated by proliferative vitreoretinopathy (PVR), the most appropriate operating method is controversial, and different surgeons use different techniques. The Scleral Buckling Versus Primary Vitrectomy in Rhegmatogenous Retinal Detachments Study (SPR Study) is designed to compare primary vitrectomy and scleral buckling techniques in these patients. Methods: The SPR Study is a multicentre, randomised, controlled clinical trial stratified by lens status. Patients with RRD which is not complicated by PVR grade B or C and which cannot be treated with a single meridional sponge are randomised to either scleral buckling or pars plana vitrectomy as first surgical intervention. Four hundred consecutive patients are to be recruited per subtrial (phakic and aphakic/pseudophakic patients), and followed up for 1 year. The primary endpoint (functional outcome) is the change in visual acuity. Secondary endpoints (anatomical outcome) include postoperative PVR, retinal reattachment and the number of reoperations necessary to achieve retinal reattachment. Twenty-seven institutions (49 surgeons) in six European countries have been recruited for participation in the study. Conclusion: The SPR Study is the first randomised prospective clinical trial to compare scleral buckling and primary vitrectomy in patients with RRD. The results of this study should enable vitreoretinal surgeons to improve the surgical therapy of patients with the more complicated manifestations of RRD.
Clinical & experimental ophthalmology, 2003
The purpose of the present paper was to compare the techniques of conventional scleral buckling and combined pars plana vitrectomy and scleral buckling procedures in rhegmatogenous retinal detachments with unseen retinal breaks. Forty-four consecutive eyes with uncomplicated, primary rhegmatogenous retinal detachments with a clear media and unseen retinal breaks were randomized to two groups. The scleral buckling group underwent 360 degrees scleral buckling, cryopexy and external subretinal fluid drainage. In the combined surgery group, 360 degrees scleral buckling, pars plana vitrectomy, air-fluid exchange, endolaser and injection of 14% perfluoropropane gas was done. At 3 months follow up the primary reattachment rate was 80% (16/20 cases) in the combined surgery group, and 70% (14/20 cases) in the scleral buckling group (P = 0.716). The visual acuity improved significantly from a preoperative median of hand movement (HM; range: HM to 6/60; similar in both the groups), to a median...
Anatomical and functional outcome of scleral buckling in primary rhegmatogenous retinal detachment
IP innovative publication pvt. ltd, 2019
Purpose: To study the anatomical and functional outcomes, complications and reasons for failure of scleral buckling in primary rhegmatogenous retinal detachment Design: Prospective Observational Study Materials and Methods: 17 eyes of 16 consecutive patients who had undergone scleral buckling for rhegmatogenous retinal detachment at a tertiary care teaching Ophthalmic Institute in South India from January 2015 were taken up for the study. Important points like history of trauma, spectacle use and cataract surgery were noted from the history. Detailed evaluation including snellen visual acuity converted to Logmar vision, Slit Lamp Evaluation, Fundus examination, Applanation tonometry etc were done and documented before surgery and the same parameters were again noted during the follow up examinations on the first post operative day and then at 2 weeks, 4 weeks, 3months and 6 months. Surgical parameters like number and location of breaks, macular status, type of buckling etc were also recorded diligently. Results: 15 Out of the 17 eyes (88%) achieved anatomical success with the retina attached at 4 weeks of post operative follow up. The cause of failure in the remaining 2 cases was missed retinal breaks and were rescued by vitrectomy. The mean average pre operative vision was 2.23 which improved to a mean average vision of 1.49, 1.30, 1.15, 1.04, 1.01 at 1st post operative day, 2weeks, 4 weeks, 3months and 6 months respectively. The change was found to be significant. The macula on RRDs (4 eyes) had better visual improvement with mean pre op Logmar vision improving from 0.842 to a post op Logmar vision of 0.37 and 0.15 at 4 weeks and 6 months respectively.
Cureus, 2020
The aim of the article is to compare scleral buckle (SB) and primary sutureless pars plana vitrectomy (PPV) without SB in rhegmatogenous retinal detachment (RRD) repair. Methods A retrospective study of rhegmatogenous RD surgeries performed between eyes with proliferative vitreoretinopathy (PVR) up to grade B and a minimum of two months postoperative follow-up were included. The primary outcome measure was an improvement in the final best-corrected visual acuity (BCVA) and secondary outcome measures were a final anatomical success, number of resurgeries, and cataract progression. Results A total of 37 eyes in the SB group and 30 eyes in the sutureless PPV group were included. The mean followup was 7.5 ± 5 months and 9 ± 4 months in the SB and PPV group, respectively. The improvement in the final BCVA from baseline was four lines in the SB group and five lines in the PPV group (p=0.87). The final anatomical success was 97% in SB and 93% in the PPV group. The number of re-surgeries for attachment of retina were higher in the PPV group, (SB: 8/37 vs PPV: 8/30 p=0.03).The number of resurgeries (16/37 vs. 33/30; p=<0.05), cataract progression (3/37 vs. 10/30; p=0.01), and the mean number of hospital visits (6 vs. 9; p=0.001) were significantly higher in the sutureless PPV group. Conclusions Visual acuity improvement and anatomical success rates were similar between SB and sutureless PPV in RRD repair. The number of operations, cataract progression, and the mean number of hospital visits were higher in the sutureless PPV group.
Primary vitrectomy for rhegmatogenous retinal detachment: an analysis of 512 cases
Graefe's Archive for Clinical and Experimental Ophthalmology, 2006
One hundred and twenty-four eyes with a rhegmatogenous retinal detachment, considered to be at high risk of failure if treated conventionally, underwent vitrectomy and internal tamponade, with or without scleral buckling, as the primary procedure. The retina was reattached in 64.5% of eyes after one operation, 75.0% after two, and in 83% of eyes after more than two operations, with no difference in the success rate between those eyes which underwent vitrectomy alone, and those that received adjunctive scleral buckling; duration of surgery was significantly shorter, however, in the former group. Twenty percent of eyes redetached in association with proliferative vitreoretinopathy, and 20% of phakic eyes developed posterior subcapsular lens opacities after surgery. Vitrectomy is now an established method in the management of selected cases of rhegmatogenous retinal detachments.