Our Summary

The study looks at how effective a procedure called scleral buckling (SB) is at treating a specific type of retinal detachment (when the retina peels away from the layer beneath it) in patients who do not have another condition called posterior vitreous detachment. The surgery was performed by the same surgeon on 244 patients between 2005 and 2014, and 40 of these patients (45 eyes) met the criteria for this study.

The researchers tracked how well the patients’ retinas reattached after the surgery and also looked at their vision results, what their retinas looked like before surgery, and the specifics of the SB procedure each patient received. The main measure of success was whether the retina stayed attached six months after the surgery.

The average age of the patients was 29, and they were followed-up for an average of 20 months after surgery. The average prescription (refractive error) of the patients was -5.16. Some patients (37.8%) had fluid drained from beneath their retinas during the surgery.

The success rate of a single SB surgery after six months was 91.1%. The only factor that significantly impacted unsuccessful surgeries was if a subretinal hemorrhage (bleeding underneath the retina) occurred during the fluid drainage process.

Even though more people are now having a different type of surgery (primary vitrectomy) for this type of retinal detachment, the study suggests that SB is a good option for younger patients who don’t have a preexisting posterior vitreous detachment. The success rate for these patients was 91.1% after one surgery and 100% after a second surgery.

FAQs

  1. What is the success rate of a primary scleral buckling surgery?
  2. Who is the ideal candidate for scleral buckling surgery according to the study?
  3. What factor significantly correlates with primary anatomical failure in scleral buckling 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 to ensure the best possible outcome. This may include avoiding strenuous activities, attending follow-up appointments, and taking any prescribed medications as directed. Additionally, patients should promptly report any changes in vision or discomfort to their doctor. It is also important to maintain regular eye exams to monitor the long-term health of the eye after surgery.

Suitable For

Patients who are typically recommended scleral buckle surgery include those with rhegmatogenous retinal detachment without posterior vitreous detachment, particularly younger patients without a preexisting posterior vitreous detachment. In this study, the mean age of patients undergoing SB was 29 years, with a mean refractive error of -5.16 diopters. Subretinal fluid drainage was performed in some cases. The primary anatomical success rate after single SB surgery was 91.1%, with the only significant factor associated with failure being the development of subretinal hemorrhage during the drainage procedure. Overall, SB showed favorable outcomes in this group of patients.

Timeline

Before scleral buckle surgery:

  • Patient presents with rhegmatogenous retinal detachment without posterior vitreous detachment
  • Preoperative retinal findings and refractive error are analyzed
  • Subretinal fluid drainage may be performed
  • The patient undergoes SB surgery

After scleral buckle surgery:

  • Anatomical success rate is assessed at 6 months post-surgery
  • Follow-up appointments are scheduled to monitor outcomes
  • Additional surgery may be required in cases of primary anatomical failure
  • Visual outcomes and overall patient satisfaction are evaluated
  • Long-term monitoring may be necessary to ensure the success of the procedure

What to Ask Your Doctor

  1. What is the success rate of scleral buckle surgery for my specific condition?
  2. What are the potential risks and complications associated with scleral buckle surgery?
  3. How long is the recovery period after scleral buckle surgery?
  4. Will I need any additional procedures or surgeries after the scleral buckle surgery?
  5. How will the scleral buckle affect my vision and eye health in the long term?
  6. Are there any lifestyle changes I need to make before or after the surgery?
  7. How often will I need follow-up appointments after the surgery?
  8. What can I expect in terms of visual outcomes after the surgery?
  9. Are there any alternative treatments to scleral buckle surgery that I should consider?
  10. Are there any specific instructions or precautions I should follow before and after the surgery to optimize the results?

Reference

Authors: Noori J, Bilonick RA, Eller AW. Journal: Retina. 2016 Nov;36(11):2066-2071. doi: 10.1097/IAE.0000000000001075. PMID: 27172097