Our Summary

This research paper is about a study into the effectiveness and safety of two treatments for a condition called giant retinal tear. The two treatments compared are: pars plana vitrectomy combined with scleral buckle (a surgical procedure where a silicone band is attached to the outside of the eye to push the wall of the eye against the detached retina), and pars plana vitrectomy alone.

The researchers searched for relevant trials in several medical databases. They only included randomized controlled trials (RCTs), which are a type of scientific experiment that is considered the most reliable form of scientific evidence in healthcare because they reduce certain types of bias.

They found two RCTs (involving 105 participants) that were relevant to their research, but neither was published in full. The limited data available suggested that the combined treatment of pars plana vitrectomy and scleral buckle might be beneficial, but the researchers couldn’t make a definitive conclusion because there was no peer-reviewed publication and not enough information to assess the risk of bias.

The authors concluded that there is no conclusive evidence from RCTs to recommend scleral buckle combined with pars plana vitrectomy for giant retinal tear. They suggest more high-quality trials are needed to fill this evidence gap. Future trials should include both short-term and long-term outcomes, and look at a variety of factors including changes in vision, whether a second surgery is required, and possible side effects like increased eye pressure and cataract progression.

FAQs

  1. What is scleral buckle surgery and how is it used in the treatment of giant retinal tear?
  2. Why was it difficult for the researchers to make a definitive conclusion about the effectiveness of scleral buckle combined with pars plana vitrectomy?
  3. What do the authors suggest for future research on the treatment of giant retinal tear?

Doctor’s Tip

A helpful tip a doctor might tell a patient about scleral buckle surgery is to follow post-operative instructions carefully to ensure proper healing and minimize complications. This may include taking prescribed medications, avoiding strenuous activities, and attending follow-up appointments with your eye surgeon. It is important to communicate any changes in your vision or any unusual symptoms to your doctor promptly.

Suitable For

Patients who are typically recommended scleral buckle surgery are those with giant retinal tears. Giant retinal tears are characterized by a full-thickness tear in the retina that extends for 90 degrees or more. These tears are typically associated with trauma or severe myopia (nearsightedness). Scleral buckle surgery is often recommended for these patients because it helps to reattach the retina and prevent further detachment.

Timeline

Before scleral buckle surgery, a patient may experience symptoms of a giant retinal tear such as flashes of light, floaters in their vision, and a curtain-like shadow over their visual field. They may undergo a thorough eye examination, including imaging tests like ultrasound or optical coherence tomography, to confirm the diagnosis.

After scleral buckle surgery, the patient may experience some discomfort, redness, and swelling in the eye. They will need to follow post-operative care instructions, such as using prescribed eye drops, avoiding strenuous activities, and attending follow-up appointments with their ophthalmologist. Over time, the silicone band will help the retina reattach and stabilize, improving the patient’s vision and reducing the risk of further complications. Follow-up visits will continue to monitor the healing process and ensure the best possible outcome for the patient.

What to Ask Your Doctor

  1. What is the success rate of scleral buckle surgery in treating giant retinal tears?
  2. What are the potential risks and complications associated with scleral buckle surgery?
  3. How long is the recovery process after scleral buckle surgery?
  4. Will I need to undergo any additional treatments or surgeries after scleral buckle surgery?
  5. How will scleral buckle surgery affect my vision in the long term?
  6. Are there any lifestyle changes or precautions I should take after undergoing scleral buckle surgery?
  7. What is the likelihood of needing a second surgery or experiencing a recurrence of the retinal tear after scleral buckle surgery?
  8. How experienced are you in performing scleral buckle surgeries, and what is your success rate with this procedure?
  9. Are there any alternative treatment options to consider besides scleral buckle surgery?
  10. How soon after the surgery will I be able to resume normal activities and work?

Reference

Authors: Gutierrez M, Rodriguez JL, Zamora-de La Cruz D, Flores Pimentel MA, Jimenez-Corona A, Novak LC, Cano Hidalgo R, Graue F. Journal: Cochrane Database Syst Rev. 2019 Dec 16;12(12):CD012646. doi: 10.1002/14651858.CD012646.pub2. PMID: 31840810