Our Summary

This research paper is a comprehensive review and analysis of studies conducted over a period of 21 years, from January 2000 to June 2021. The studies were about two different techniques used to repair a specific type of retinal detachment known as rhegmatogenous retinal detachment. The two techniques are scleral buckling (SB) and a combination of scleral buckling and pars plana vitrectomy (SB + PPV).

The main goal of the analysis was to compare the effectiveness and safety of the two methods. The primary measure of effectiveness was the final best-corrected visual acuity (BCVA), which is a measure of the sharpest vision a person can achieve. Secondary measures included the rate of successful reattachment of the retina and the occurrence of negative side effects.

The analysis included 18 studies involving 3912 eyes treated with SB and 3300 eyes treated with SB + PPV. The results showed no significant difference in the final BCVA between the two methods. The rate of successful reattachment was also similar for both methods; however, SB alone had a slightly higher final reattachment rate.

In terms of safety, compared to SB + PPV, the SB only method had a significantly lower risk of two specific complications after surgery: swelling of the macula (the central part of the retina) and cataract (clouding of the eye’s lens). The risk of other complications, such as macular hole, elevated eye pressure, and muscle dysfunction, was similar for both methods.

In conclusion, this research suggests that both methods are effective for repairing rhegmatogenous retinal detachment with no significant difference in the final vision outcome. However, using SB alone may offer a slightly higher success rate in reattaching the retina and lower risks of certain complications after surgery.

FAQs

  1. What is the difference in final best-corrected visual acuity (BCVA) between scleral buckling (SB) and the combination of SB and pars plana vitrectomy (SB + PPV) for rhegmatogenous retinal detachment (RRD) repair?
  2. How does the primary reattachment rate and final reattachment rate compare between scleral buckling (SB) alone and a combination of SB and pars plana vitrectomy (SB + PPV) for rhegmatogenous retinal detachment (RRD) repair?
  3. What is the risk of postoperative complications such as macular edema and cataract formation in scleral buckling (SB) alone versus a combination of SB and pars plana vitrectomy (SB + PPV) for rhegmatogenous retinal detachment (RRD) repair?

Doctor’s Tip

One helpful tip a doctor might tell a patient about scleral buckle surgery is to follow post-operative care instructions carefully, including avoiding strenuous activities and taking prescribed medications as directed to promote proper healing and reduce the risk of complications.

Suitable For

Scleral buckle surgery is typically recommended for patients with rhegmatogenous retinal detachment. This procedure may be considered for patients who have not responded well to other treatments or have a high risk of retinal detachment recurrence. Patients with certain types of retinal tears or holes may also benefit from scleral buckle surgery. It is important for the patient to undergo a thorough evaluation by an ophthalmologist to determine if scleral buckle surgery is the appropriate treatment option for their specific condition.

Timeline

Before scleral buckle surgery:

  1. Patient presents with symptoms of rhegmatogenous retinal detachment, such as floaters, flashes of light, and a curtain-like shadow over vision.
  2. Patient undergoes a comprehensive eye examination, including visual acuity testing, tonometry, and dilated eye exam, to confirm the diagnosis of retinal detachment.
  3. Patient discusses treatment options with their ophthalmologist, including scleral buckle surgery as a possible intervention.
  4. Patient undergoes preoperative testing and evaluation to ensure they are a suitable candidate for scleral buckle surgery.

After scleral buckle surgery:

  1. Patient undergoes the surgical procedure, which involves placing a silicone band around the eye to support the detached retina.
  2. Patient is monitored closely in the immediate postoperative period for any signs of complications, such as infection or increased intraocular pressure.
  3. Patient may experience some discomfort and blurred vision in the days following surgery, which typically improves over time.
  4. Patient attends follow-up appointments with their ophthalmologist to assess the success of the surgery and monitor for any long-term complications.
  5. Patient may undergo additional interventions, such as laser therapy or cryopexy, to further support retinal reattachment if needed.

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 undergo additional procedures or follow-up appointments after the surgery?
  4. How successful is scleral buckle surgery in repairing retinal detachment?
  5. Are there any lifestyle changes or restrictions I should follow post-surgery?
  6. How will my vision be affected after the surgery?
  7. What is the expected outcome in terms of visual acuity and reattachment rates?
  8. How experienced are you in performing scleral buckle surgery?
  9. Are there any alternative treatment options to consider?
  10. What should I do if I experience any complications or side effects after the surgery?

Reference

Authors: Nichani PAH, Dhoot AS, Popovic MM, Eshtiaghi A, Mihalache A, Sayal AP, Yu HJ, Wykoff CC, Kertes PJ, Muni RH. Journal: Ophthalmologica. 2022;245(4):296-314. doi: 10.1159/000524888. Epub 2022 May 9. PMID: 35533652