Our Summary

This research paper compares two surgical methods for treating a common type of retinal detachment. The first method is called pars plana vitrectomy (PPV), and the second is a combination of PPV and a procedure called scleral buckle (PPV-SB).

The study looked back at data from patients treated at a single hospital between 2014 and 2018. In total, 1,516 patients were included in the initial analysis, and a subset of 908 patients were specifically matched based on certain characteristics to ensure a fair comparison.

The main goal of the study was to see whether one surgical method resulted in better anatomical success after a single surgery. Anatomical success refers to the retina being properly reattached after surgery. The study also looked at patients’ visual acuity (how clear their vision was) 3 months after surgery and at their final check-up.

The results showed that there was no significant difference in the anatomical success rate between the two surgical methods. In terms of visual acuity, patients who only had the PPV surgery had slightly better vision at 3 months and at their final check-up.

So, the study concluded that adding a scleral buckle to the PPV surgery didn’t improve the success rate of the surgery in reattaching the retina. Also, it was associated with slightly worse vision in the follow-up period.

FAQs

  1. What are the two surgical methods for treating retinal detachment compared in this study?
  2. What does the term “anatomical success” refer to in this context?
  3. Did adding a scleral buckle to the PPV surgery improve the success rate of the surgery or the patients’ visual acuity?

Doctor’s Tip

A helpful tip a doctor might tell a patient about scleral buckle surgery is to follow all post-operative instructions carefully, including taking any prescribed medications, attending follow-up appointments, and avoiding strenuous activities that could put strain on the eye. It’s important to be patient during the recovery process and to communicate any concerns or changes in vision to your healthcare provider.

Suitable For

Patients with retinal detachment, specifically those with rhegmatogenous retinal detachment, are typically recommended scleral buckle surgery. This type of retinal detachment occurs when a tear or hole in the retina allows fluid to build up under the retina, causing it to detach from the back of the eye. Scleral buckle surgery involves placing a silicone band around the eyeball to indent the wall of the eye and bring the tear in the retina into contact with the wall of the eye, allowing it to heal.

Patients who have a high likelihood of success with scleral buckle surgery include those with a single retinal tear, a relatively uncomplicated detachment, and good overall eye health. Patients with more complicated detachments or other eye conditions may not be good candidates for this type of surgery and may require alternative treatments.

It is important for patients to discuss their individual case with their ophthalmologist to determine the most appropriate treatment plan for their specific situation.

Timeline

Before scleral buckle surgery:

  • Patient experiences symptoms of retinal detachment such as floaters, flashes of light, and a curtain or shadow over their field of vision
  • Patient undergoes a comprehensive eye examination by an ophthalmologist to confirm the diagnosis of retinal detachment
  • Surgical options are discussed with the patient, including scleral buckle surgery
  • Pre-operative tests are conducted to assess the patient’s overall eye health and determine the extent of the retinal detachment
  • Patient is informed about the risks and benefits of the surgery and gives consent for the procedure

After scleral buckle surgery:

  • Patient undergoes the surgical procedure, during which a silicone band is placed around the eye to support the detached retina
  • Patient may experience discomfort, blurry vision, and sensitivity to light immediately after the surgery
  • Patient is prescribed medications to manage pain and prevent infection
  • Patient is instructed to avoid strenuous activities and to keep their head in a certain position to aid in the healing process
  • Follow-up appointments are scheduled to monitor the progress of the recovery and assess the success of the surgery in reattaching the retina
  • Patient may experience gradual improvement in vision over time, but may also have some changes in vision due to the surgery

Overall, the timeline of a patient’s experience before and after scleral buckle surgery involves initial symptoms and diagnosis, pre-operative preparation, the surgical procedure itself, post-operative care, and follow-up appointments to monitor the outcomes of the surgery.

What to Ask Your Doctor

Some questions a patient should ask their doctor about scleral buckle surgery include:

  1. What is scleral buckle surgery and how does it differ from other surgical methods for treating retinal detachment?
  2. What are the potential risks and complications associated with scleral buckle surgery?
  3. How long is the recovery period after scleral buckle surgery and what can I expect during this time?
  4. What is the success rate of scleral buckle surgery in reattaching the retina?
  5. Will I need to undergo any additional procedures or follow-up appointments after scleral buckle surgery?
  6. How will scleral buckle surgery affect my vision and are there any potential long-term effects to consider?
  7. Are there any specific lifestyle changes or precautions I should take after undergoing scleral buckle surgery?
  8. What is the experience and success rate of the surgeon performing the scleral buckle surgery?
  9. Are there any alternative treatment options to consider besides scleral buckle surgery?
  10. How can I best prepare for scleral buckle surgery in terms of medication, diet, and overall health?

Reference

Authors: Hébert M, You E, Garneau J, Qi SR, Bourgault S, Caissie M, Tourville É, Dirani A. Journal: Retina. 2022 Jun 1;42(6):1161-1169. doi: 10.1097/IAE.0000000000003425. PMID: 35174803