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Addition of scleral buckle may not improve surgical outcomes for pars plana vitrectomy
Am J Ophthalmol. 2011;152(2):291-297.
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Eyes that undergo pars plana vitrectomy with a scleral buckle for primary rhegmatogenous retinal detachment may not experience enhanced surgical outcomes, according to a study.
“Our data indicate that the addition of a [scleral buckle] does not improve the success rates and is associated with longer surgical time and more frequent use of general anesthesia,” the authors wrote.
The retrospective, nonrandomized, interventional case series reviewed 96 eyes that underwent pars plana vitrectomy (PPV) and 85 eyes that underwent PPV plus scleral buckle. Surgery was performed at two medical centers in Israel, and mean follow-up was 12.8 ± 11.2 months for PPV patients and 11.7 ± 8.9 months for PPV plus scleral buckle patients.
Single-surgery anatomic success rates in the PPV and PPV plus scleral buckle groups were 81.3% and 87.1%, respectively. Final anatomic success rates were also similar: 98.9% and 98.8%. Visual acuity significantly improved in the two sets of patients (P < .0001), with the PPV and PPV plus scleral buckle groups achieving a mean acuity of 20/51 and 20/68, respectively.
Moreover, the addition of a scleral buckle did not change the rate of proliferative vitreoretinopathy, the most serious known complication of retinal detachment surgery. Tear location (ie, inferior or superior breaks) and lens status had no significant effect on success.