Our Summary

The study compares two types of surgery used to treat a condition where the retina detaches from the back of the eye. The first method, scleral buckle surgery, involves placing a flexible band around the eye to push the wall of the eye against the detached retina. The second method, pneumatic retinopexy, uses a gas bubble to push the retina back into place, and can be combined with the buckle surgery.

The researchers looked back at medical data from two groups of patients, one group who had the buckle surgery and another group who had the buckle surgery combined with the gas bubble method. They followed up with these patients for at least a year to see how their vision was and whether the retina stayed in place.

The results showed that both methods were pretty good at keeping the retina in place. But, the group who only had the buckle surgery had slightly better vision on average compared to the group who had the combined surgery. Also, the buckle surgery group had more patients needing extra laser treatments and adjustments to the buckle, while the combined surgery group had more patients needing another type of eye surgery after their initial operation.

So, the study suggests that the buckle surgery on its own is usually a good treatment for a detached retina, and adding the gas bubble method doesn’t really improve the chances of the retina staying in place.

FAQs

  1. What is the purpose of scleral buckle surgery?
  2. How do the outcomes of scleral buckle surgery alone compare to when it’s combined with pneumatic retinopexy for treating rhegmatogenous retinal detachment?
  3. What were the main complications observed in the study of scleral buckle surgery?

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 keeping the eye clean and avoiding activities that may put strain on the eye. It is also important to attend all follow-up appointments to ensure proper healing and monitor for any potential complications. Additionally, patients should report any sudden changes in vision or worsening symptoms to their doctor immediately.

Suitable For

Patients with primary rhegmatogenous retinal detachment are typically recommended scleral buckle surgery. This study found that scleral buckle surgery alone is efficient for the treatment of rhegmatogenous retinal detachment, with high rates of anatomical reattachment. The study also compared outcomes and complications of scleral buckle surgery alone versus combined with pneumatic retinopexy, and found that the combination usually has no significant added value in terms of anatomical reattachment rate. Overall, scleral buckle surgery is a common and effective treatment for patients with rhegmatogenous retinal detachment.

Timeline

  • Before scleral buckle surgery:
  1. Patient experiences symptoms of rhegmatogenous retinal detachment, such as sudden onset of floaters, flashes of light, or a shadow in their peripheral vision.
  2. Patient undergoes a comprehensive eye examination to confirm the diagnosis of retinal detachment.
  3. Patient may undergo preoperative tests, such as ultrasound or optical coherence tomography, to assess the extent of the detachment.
  4. Patient discusses the risks and benefits of scleral buckle surgery with their ophthalmologist and consents to the procedure.
  • After scleral buckle surgery:
  1. Patient undergoes the surgical procedure, which involves the placement of a silicone band around the eye to support the detached retina.
  2. Patient may experience discomfort, redness, or swelling in the eye following surgery.
  3. Patient is advised to avoid strenuous activities and to follow postoperative care instructions, such as using eye drops and attending follow-up appointments.
  4. Patient’s vision gradually improves over time as the retina reattaches and heals.
  5. Patient may require additional procedures, such as laser applications or buckle readjustment surgery, to ensure the success of the retinal reattachment.
  6. Patient is monitored for complications, such as infection or recurrence of retinal detachment, during the postoperative period.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with scleral buckle surgery?
  2. How long is the recovery period after scleral buckle surgery?
  3. Will I need to wear any special eye protection or take any precautions after surgery?
  4. How successful is scleral buckle surgery in reattaching the retina?
  5. Are there any alternative treatment options to scleral buckle surgery that I should consider?
  6. What is the likelihood of needing additional surgeries or procedures after scleral buckle surgery?
  7. How soon after surgery will I be able to resume normal activities and work?
  8. Will I need to follow up with regular appointments or tests after surgery?
  9. How will scleral buckle surgery affect my vision in the long term?
  10. Are there any specific lifestyle changes or medications I should be aware of after scleral buckle surgery?

Reference

Authors: Weinberger Y, Sternfeld A, Hadar-Cohen N, Tennant MTS, Dotan A. Journal: Eur J Ophthalmol. 2022 Sep;32(5):2840-2844. doi: 10.1177/11206721211064035. Epub 2021 Nov 29. PMID: 34841941