Our Summary

This study looked at the outcomes of a surgical procedure called scleral buckling, which treats a condition where the retina (the layer at the back of the eye that senses light) detaches from the rest of the eye. The researchers looked at the medical records of 203 patients who had this operation to see how well it worked and what factors affected the results.

The medical records provided information about the patients’ characteristics, how long they’d had symptoms, the state of their vision, the condition of the lens in their eye, where the retina had broken, how much it had detached, whether the other eye was also affected, whether the macula (the part of the retina responsible for sharp, central vision) was involved, whether they had a condition called lattice degeneration, and any associated errors in the way their eyes refracted light. They also looked at whether the retina reattached after surgery, changes in vision, whether more surgery was needed, and complications during and after surgery.

They found that, in most cases (83.5%), the retina reattached after the surgery. The average vision improved after the operation, and the biggest factors that influenced the results were how long the macula had been detached and the state of the lens in the eye. Eyes that still had their natural lens had better results than those that had artificial lenses or no lens at all.

In conclusion, the scleral buckling procedure worked well in most cases, with good improvements in vision, especially in cases where the macula had not been detached for long and where the eye still had its natural lens. The researchers believe that this procedure can give the best results with the least cost and the least need for additional surgeries when used in the right cases.

FAQs

  1. What is the purpose of the study on scleral buckling surgery?
  2. What factors were evaluated in the study of scleral buckling surgery for rhegmatogenous retinal detachment?
  3. What were the significant factors affecting the anatomical and visual outcomes of scleral buckling surgery according to the study?

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 eyes. It is also important to report any sudden changes in vision or increase in pain to the doctor immediately. Following these guidelines can help ensure a successful outcome and faster recovery.

Suitable For

Patients with rhegmatogenous retinal detachment (RRD) who are recommended scleral buckle surgery typically present with symptoms such as decreased vision, flashes of light, and floaters. They may have a history of trauma, myopia, or previous cataract surgery. Factors that may affect the success of scleral buckle surgery include the duration of macular detachment, lens status (phakic, aphakic, pseudophakic), site of retinal break, extent of retinal detachment, macular involvement, presence of lattice degeneration, and associated refractive errors. Patients with shorter durations of macular detachment and phakic eyes tend to have better visual outcomes following scleral buckle surgery. Scleral buckle surgery is considered a cost-effective and successful treatment option for patients with RRD.

Timeline

  • Patient presents with symptoms of rhegmatogenous retinal detachment (RRD), such as floaters, flashes of light, and vision loss.
  • Patient undergoes a comprehensive eye examination, including dilated fundus examination, to confirm the diagnosis of RRD.
  • Surgical consultation is scheduled, and the patient is informed about the scleral buckling procedure and its risks and benefits.
  • Preoperative testing, including imaging studies and blood tests, may be performed to assess the patient’s overall health and suitability for surgery.
  • On the day of surgery, the patient is admitted to the hospital or surgical center and undergoes the scleral buckling procedure under local or general anesthesia.
  • During the surgery, the retinal break is identified and sealed with a scleral buckle, which supports the retina and helps it reattach.
  • After the surgery, the patient may experience some discomfort, redness, and swelling in the eye, which can be managed with pain medication and eye drops.
  • The patient is closely monitored for any signs of complications, such as infection or increased intraocular pressure.
  • Follow-up appointments are scheduled to assess the postoperative healing process, monitor the reattachment of the retina, and evaluate the visual acuity.
  • In the weeks and months following surgery, the patient’s vision gradually improves as the retina reattaches and heals, leading to a significant improvement in visual acuity.
  • The patient may require additional follow-up visits to monitor long-term outcomes and address any potential complications or recurrence of retinal detachment.

What to Ask Your Doctor

  1. What is scleral buckle surgery and how does it work to repair a retinal detachment?
  2. What are the potential risks and complications associated with scleral buckle surgery?
  3. How long is the recovery process after scleral buckle surgery and what can I expect in terms of post-operative care?
  4. Will I need to follow up with additional appointments or procedures after the surgery?
  5. How successful is scleral buckle surgery in reattaching the retina and improving vision?
  6. What factors can affect the success of the surgery, such as the duration of macular detachment or the status of the lens?
  7. Are there any specific lifestyle changes or precautions I should take after the surgery to support the healing process?
  8. How will my vision be affected after the surgery, and what are the expectations for visual acuity improvement?
  9. Are there any alternative treatment options to consider, and how do they compare to scleral buckle surgery in terms of effectiveness and risks?
  10. What is the long-term outlook for my eye health and vision after undergoing scleral buckle surgery?

Reference

Authors: Sharma RK, Akkawi MT, Shehadeh MM, Aghbar AA, Qaddumi J. Journal: Middle East Afr J Ophthalmol. 2020 Jul 20;27(2):100-104. doi: 10.4103/meajo.MEAJO_94_18. eCollection 2020 Apr-Jun. PMID: 32874042